Psychosis as an Early Manifestation of Neuropsychiatric Systemic Lupus Erythematosus – A Case Report

July 2023

Widya Wirasasmita Mirsan, Femi Syahriani, Faridin Pango, Endy Adnan, Abdul Rahman Umar

hair loss systemic lupus erythematosus SLE neuropsychiatric systemic lupus erythematosus NPSLE corticosteroids immunosuppressants lupus steroids

TLDR Psychosis can be an early sign of neuropsychiatric lupus, treatable with tailored medication.

This case report describes a 19-year-old woman who presented with psychosis and seizures as early manifestations of neuropsychiatric systemic lupus erythematosus (NPSLE). She exhibited symptoms such as visual and auditory hallucinations, fever, malar rash, hair loss, and arthritis. Laboratory tests revealed anemia, lymphopenia, increased CRP, positive immunoserological results, and decreased C3 and C4 complement levels. Despite normal brain MSCT findings, she was diagnosed with SLE with neuropsychiatric manifestations based on the SLICC criteria. The patient showed significant improvement with a combination of high-dose corticosteroids, immunosuppressants, and antidepressants. The report emphasizes that NPSLE treatment is tailored to individual symptoms, similar to general SLE management.

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