Catatonia as the Presenting Symptom in Systemic Lupus Erythematosus

Abstract

Catatonia is a syndrome of physical and behavioral abnormalities that can result from psychiatric, neurological, or medical illness. Although systemic lupus erythematosus (SLE) is commonly known to cause neurological and psychiatric manifestations, it has only rarely been reported to cause the catatonic syndrome. In nearly all previously reported cases, the diagnosis of catatonia was reported in patients with an established diagnosis of lupus. We report a case in which a woman with no known medical history presented with catatonia that did not respond to standard treatment with benzodiazepines, suffered a long and complicated hospital course, and was eventually diagnosed with lupus. With initiation of treatment for lupus, her symptoms of catatonia remitted. This case illustrates the importance of considering medical causes in the diagnosis and treatment of psychiatric disorders, especially the catatonic syndrome.

Catatonia in systemic lupus erythematosus: a case report and review of literature

“…Some of the cases reported catatonia as the initial presentation only to be later confirmed as cases of SLE. 4,14,16 Catatonia was also reported in patients known to have SLE in association with lupus relapse. 12 The same was observed in the index case.…”

“…After a thorough PubMed search in January 2013 and after checking all of the cross references, we could find only 22 cases of catatonic symptoms in SLE reported in the literature. Details of 19 such cases [4][5][6][7][8][9][10][11][12][13][14][15] are shown in Table 1. We were unsuccessful in obtaining details of three case reports.…”

Antiphospholipid antibodies as biomarkers in psychiatry: review of psychiatric manifestations in antiphospholipid syndrome

“…Although the classification criteria for SLE were not met, the authors postulated that the inflammatory disorder (as indicated by elevated erythrocyte sedimentation rate and C-reactive protein) may have indicated an early stage of this disease (52). Catatonia is now considered to be a manifestation of SLE, and its pathogenesis in this instance may be related to the affinity of aPL antibodies for the basal ganglia (53). Pego-Reigosa studied 11 patients with lupus psychosis, and aPL were observed in 10% of the cases (54).…”

Neutrophil-lymphocyte ratio in catatonia

“…Also there are studies suggest that auto-immune diseases increase the risk of schizophrenia and bipolar disorders 21,22 . It has been reported that systemic lupus erythematous which is a chronic inflammatory auto-immune disease presented with catatonia symptoms and was improved with lupus treatment 23 .…”