Abstract
Objectives Discuss neuropsychiatric aspects and differential diagnosis of catatonic syndrome secondary to systemic lupus erythematosus (SLE) in a pediatric patient. Methods Single case report. Result A 13-year-old male, after two months diagnosed with SLE, started to present psychotic symptoms (behavioral changes, hallucinations and delusions) that evolved into intense catatonia. During hospitalization, neuroimaging, biochemical and serological tests for differential diagnosis with metabolic encephalopathy, neurological tumors and neuroinfections, among other tests, were performed. The possibility of neuroleptic malignant syndrome, steroid-induced psychosis and catatonia was also evaluated. A complete reversal of catatonia was achieved after using benzodiazepines in high doses, associated with immunosuppressive therapy for lupus, which speaks in favor of catatonia secondary to autoimmune encephalitis due to lupus. Conclusion Although catatonia rarely is the initial clinical presentation of SLE, the delay in recognizing the syndrome can be risky, having a negative impact on prognosis. Benzodiazepines have an important role in the catatonia resolution, especially when associated with parallel specific organic base cause treatment. The use of neuroleptics should be avoided for the duration of the catatonic syndrome as it may cause clinical deterioration.
Highlights
Catanonia has been reported in the clinical spectrum of systemic lupus erythematosus neuropsychiatric (SLENP) manifestations
Catatonia as an expression of a pure mental disorder is a diagnosis of exclusion[3] and it has usually a recognizable organic component[4], when placing it into an organic mental syndrome, psychiatrist evaluation is valuable since the clinical manifestations are mainly mental and beha vioral[5]
The concern to validate clinical spectrum of SLENP manifestations led to studies that revealed the presence of these signs and symptoms in up to two thirds of the patients, and it may include psychosis, cognitive dysfunction and delirium[11]
Summary
Catanonia has been reported in the clinical spectrum of systemic lupus erythematosus neuropsychiatric (SLENP) manifestations. It represents a complex syndrome characterized mainly by stupor, mutism, negativism, waxy flexibility, stereotypy, automatic obedience, echo phenomena (inclu ding echolalia and echopraxia)[1]. Catatonia can be caused by a large variety of metabolic, neurologic, psychiatric and intoxication conditions, including neuroleptic malignant syndrome[2]. Catatonia has been rarely reported as an SLENP manifestation in pediatric patients[9,10]. This article is apparently unique at medical database since it reports the case of the first young male with catatonia due to lupus
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
