Citation

Datcheva V, Dimov D, Stoimenova M, Drandarska I. Revmatologiia 2000; 8(3): 28-32.

Copyright

(Copyright © 2000)

DOI

unavailable

PMID

unavailable

Abstract

The wide clinical spectrum of systemic lupus erythematosus (SLE) comprises and the lupus psychoses, accepted in the presence of depression, mania, paranoia, hallucinations or catatonia with no other cause. The incidence, morphology and pathophysiological mechanism of lupus psychoses are theoretical problems but their diagnosis and adequate treatment are of practical interest. We report on two cases thus confirming the difficulties in diagnosis and therapy of lupus psychoses. The first case is a 72 years old female patient. After an underestimated 6-month psychotic introduction she developed a delirious-amential syndrome and paranoid delusion, together with fever, lung disorder, articular syndrome, lymphopenia and elevated ESR. For the next three months she has been medicated with psychotropic drugs and antibiotics consecutively in psychiatric, pulmonary and neurological clinics because of an inexact interpretation of the gradually interpolating exanthema, proteinuria, hypertonia and even the positive immunological tests for SLE. After a reassessment of the diagnosis followed by a treatment with GCS, anticoagulants, etc. the somatic and psychic status normalized slowly and the patient was discharged from hospital with supporting doses of GCS and psychotropic drugs. The second case is a 26 years old patient with a year lasting SLE and with a new exacerbation after self-willed stopping of the supporting therapy. After pulse and per os treatment with GCS, an agitated anxiety with tendency to suicide, disorientation, psychomotor excitement and mental perception disorders occurred accompanied by fever of 39°C. After a sedation the patient fell into a catatonic stupor and mutism. In spite of the administered therapy with antibiotics and immunovenin and medicated with GCS and psychotropic drugs, the patient developed bilateral pneumonia and died.

Language: en

Keywords

adult; aged; arthropathy; article; case report; catatonia; depression; disorientation; erythrocyte sedimentation rate; female; fever; glucocorticoid; Glucocorticoids, synthetic; hallucination; human; lung disease; Lupus erythematosus, systemic/physiopathology; lymphocytopenia; mania; muscle hypertonia; paranoia; perception disorder; proteinuria; psychomotor disorder; psychosis; Psychotic disorders; psychotropic agent; rash; suicidal behavior; systemic lupus erythematosus