Catatonia due to systemic lupus erythematosus

Jornal Brasileiro de Psiquiatria

Francisco De Assis Pinto Cabral Júnior Rabello¹  Daniel Calich Luz¹  Evânia Claudino Queiroga De Figueiredo¹  Edmundo De Oliveira Gaudêncio¹  Larissa Cristina Queiroga Mendonça Coutinho¹  Waldeneide Fernandes De Azevedo¹ 

关键词: Catatonia;    systemic lupus erythematosus;    benzodiazepines;    differential diagnosis;    Catatonia;    lúpus eritematoso sistêmico;    benzodiazepínicos;    diagnóstico diferencial;   

DOI  :  10.1590/0047-2085000000022

来源: SciELO

【 摘 要 】

ObjectivesDiscuss neuropsychiatric aspects and differential diagnosis of catatonic syndrome secondary to systemic lupus erythematosus (SLE) in a pediatric patient. MethodsSingle case report. ResultA 13-year-old male, after two months diagnosed with SLE, started to present psychotic symptoms (behavioral changes, hallucinations and delusions) that evolved into intense catatonia. During hospitalization, neuroimaging, biochemical and serological tests for differential diagnosis with metabolic encephalopathy, neurological tumors and neuroinfections, among other tests, were performed. The possibility of neuroleptic malignant syndrome, steroid-induced psychosis and catatonia was also evaluated. A complete reversal of catatonia was achieved after using benzodiazepines in high doses, associated with immunosuppressive therapy for lupus, which speaks in favor of catatonia secondary to autoimmune encephalitis due to lupus. ConclusionAlthough catatonia rarely is the initial clinical presentation of SLE, the delay in recognizing the syndrome can be risky, having a negative impact on prognosis. Benzodiazepines have an important role in the catatonia resolution, especially when associated with parallel specific organic base cause treatment. The use of neuroleptics should be avoided for the duration of the catatonic syndrome as it may cause clinical deterioration.

【 授权许可】

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