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Sun lupus and energy. Systemic lupus erythematosus presenting as mania

Published online by Cambridge University Press:  23 March 2020

M.J. Gordillo Montaño
Affiliation:
Hospital Can Misses, psychiatry, Eivissa, Spain
S. Ramos Perdigues
Affiliation:
Hospital Can Misses, psychiatry, Eivissa, Spain
M.A. Artacho Rodriguez
Affiliation:
Hospital Can Misses, medicine, Eivissa, Spain
S. Latorre
Affiliation:
Hospital Can Misses, psychiatry, Eivissa, Spain
C. Merino del Villar
Affiliation:
Hospital Can Misses, psychiatry, Eivissa, Spain
C. Caballero Roy
Affiliation:
Hospital Can Misses, psychiatry, Eivissa, Spain
S.V. Boned Torres
Affiliation:
Hospital Can Misses, psychiatry, Eivissa, Spain
M. de Amuedo Rincon
Affiliation:
Hospital Can Misses, psychiatry, Eivissa, Spain
P. Torres Llorens
Affiliation:
Hospital Can Misses, psychiatry, Eivissa, Spain
M. Segura Valencia
Affiliation:
Hospital Can Misses, psychiatry, Eivissa, Spain

Abstract

Introduction

Systemic lupus erythematosus is a chronic disease that can give neuropsychiatric episodes and systemic manifestations. About 57% of patients with SLE have neuropsychiatric manifestations in the course of their illness, however an initial presentation with neuropsychiatric clinic is rare.

Objective

Describe how patients receiving corticosteroids as part of their treatment can develop mental disorders but not only them.

Method

It will raise grounds with a case: 20-year-old woman recently diagnosed with SLE because of arthritis in his ankle. Treatment was initiated with prednisone 10 mg and chloroquine 200 MG. After 20 days the patient comes to the emergency after episode of turmoil at home with major affective clinical maniform. Presenting fever. The presence of fever downloads the possibility of a psychosis chloroquine or corticosteroids to be a small dose. Treatment was initiated with high doses of prednisone and immunosuppressants. In addition to associating specific anticonvulsant and antipsychotic drugs at usual doses for a manic episode.

Results

Treatment of psychosis in SLE is essentially empirical, and depends on the etiology. It usually responds to the use of high doses of corticosteroids combined with immunosuppressive drugs. Psychosis induced by corticosteroids requires lowering them. It is valid concomitant use of antipsychotics.

Conclusions

The presence of psychotic symptoms in a patient with systemic lupus erythematosus forces to distinguish between various etiological possibilities.

Corticosteroids may cause a variety of psychiatric symptoms. And yet, in patients with SLE these syndromes are not always attributable to the use of corticosteroids.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster viewing: Consultation liaison psychiatry and psychosomatics
Copyright
Copyright © European Psychiatric Association 2017
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