Neuropsychiatric presentation of SLE and outcome: A case report

Abstract

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder. The 2019 European League against Rheumatism/American College of Rheumatology classification criteria for SLE include at least one positive antinuclear antibody test as a mandatory entry criterion, followed by additive weighted standards grouped in seven Clinical (constitutional, hematological, neuropsychiatric, serosal, musculoskeletal, renal, and mucocutaneous) and three immunological (antiphospholipid antibodies, complement proteins, and SLE‐specific antibodies) domains weighted from 2 to 10, with patients accumulating ≥10 points being diagnosed with SLE. Neuropsychiatric systemic lupus erythematosus (NPSLE) is a severe form of SLE. In around 30% of patients with neuropsychiatric symptoms SLE may be the primary cause. Symptoms manifest more frequently around onset of SLE. The suggested pathogenesis is both neuro-inflammatory and ischemic mechanisms. The diagnosis and management of NPSLE has many problems because of lack of specific diagnostic criteria and limited management guidelines. It is associated with high morbidity and mortality. Herein we present a rare and severe form SLE in an adolescent female. She has presented with neurological symptom in form of seizure and behavioral changes in form of vacant look and had poor outcome.