P-MD021. Drug induced extrapyramidal syndrome in a young girl diagnosed to be SLE

Abstract

Introduction . Extrapyramidal syndrome is a unique neurological entity. Drugs are an important aetiology capable of causing it at any age group, esp young to adults. SLE is a common autoimmune disease affecting young females and gas a myriad if presentations. Results . This 18 year old girl presented with sudden onset tremulousness of body for 10 days along with difficulty to move her limbs for 6 days. She was on olanzapune and valproate for LADT 3 months because of behavioural abnormalities in the form of abnormal cries/laughters, agitation, aggresive behaviour, convulsions. Her vitals were normal, and systemic examination showed generalised rigidity with tremors. She was evaluated for NMS but her CPK was mildly elevated. She was treated for eps with fluids, stoppage of valproate and olanzapine, initiation of levetiracetam, lorazepam and supportive care. Her workup revealed the diagnosis of SLE with positive anti-ribosomal antibody. She was started on steroids and she is off antipsychotics during her follow-up, doing well. Conclusion . It is equally prudent to find out the cause for need of antipsychotics rather than just its initiation. SLE is an important entity that should be evaluated for psychosis in young females. Immunosuppression is the key for treatment in SLE.