Indian Journal of Private Psychiatry

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VOLUME 16 , ISSUE 2 ( July-December, 2022 ) > List of Articles


Neuropsychiatric Presentation of Systemic Lupus Erythematosus—When to Attribute: A Case Report

Sashi Bhushan Gupta, Suganya Ponnaiah Pillai Krishna Pillai, Mahesh Gowda, S Preeti, Sanjiv Chamraj, M Chandrashekar

Keywords : NP syndromes, Psychosis, SLE

Citation Information : Gupta SB, Pillai SP, Gowda M, Preeti S, Chamraj S, Chandrashekar M. Neuropsychiatric Presentation of Systemic Lupus Erythematosus—When to Attribute: A Case Report. Ind J Priv Psychiatry 2022; 16 (2):91-92.

DOI: 10.5005/jp-journals-10067-0097

License: CC BY-NC 4.0

Published Online: 31-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Systemic lupus erythematosus (SLE) is an autoimmune disease with the involvement of various systems. Neuropsychiatric symptoms of SLE (NPSLE) are nonspecific. The attribution of NP symptoms is difficult. We report a case with NP symptoms followed up for more than 20 years which tested positive for SLE. Introduction: SLE is a chronic autoimmune disease that is known to affect different organs in the body.1 The diagnostic criteria of the disease have evolved over time, and the prevalence of the illness has also gradually increased. Nervous system involvement is common and can manifest as neurological or NP symptoms. The American College of Rheumatology has set definitions for 19 NP syndromes [12 central nervous system (CNS) and 7 peripheral nervous system (PNS)] deemed to occur in SLE, which is widely used in clinical practice and for research.1 These NP syndromes are classified into frequent, common, infrequent, and rare based on the frequency of the symptoms.2 None of the NP syndromes is specific for SLE; however, one-third of the NP syndromes are related to SLE autoimmunity.2 Determination and attribution of NP syndromes to SLE in patients is a challenging but critical step in treatment.2 Among psychiatric syndromes, mood disorder and anxiety have been found to be frequent compared with psychosis, which is infrequent.3

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  1. Hu B, Wu P, Zhou Y, et al. A case of neuropsychiatric lupus erythematosus characterized by the Owl's eye sign: A case report. BMC Neurol 2017;17(1):1–5. DOI: 10.1186/s12883-017-0902-6.
  2. Govoni M, Hanly JG. The management of neuropsychiatric lupus in the 21st century: Still so many unmet needs? Rheumatol (United Kingdom) 2020;59:V52–V62. DOI: 10.1093/rheumatology/keaa404.
  3. Schwartz N, Stock AD, Putterman C. Neuropsychiatric lupus: New mechanistic insights and future treatment directions. Nat Rev Rheumatol 2019;15(3):137–152. DOI: 10.1038/s41584-018-0156-8.
  4. Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Arthritis & rheumatology 2019;71(9):1400–1412. DOI: 10.1002/art.40930.
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