A 32-year-old woman presented with complaints of excessive talk, irritability, and reduced sleep for 3 days. The patient had a history of fever with a rash before the onset of psychiatric symptoms. Past psychiatric history indicated that she had 2 similar episodes of fever followed by psychiatric symptoms 10 years ago. There was no family history of psychiatric illness. Her mental status revealed hyperactivity, over productive pressured speech, labile affect, and no insight. The patient also had a history of untreated polyarthralgia and recurrent oral ulcers. A provisional diagnosis of organic mood disorder was made. Oral olanzapine 2.5 mg was started to control her psychiatric symptoms. Her blood investigations indicated a high erythrocyte sedimentation rate, positive antinuclear antibody profile, and positive Smith antibodies. A diagnosis of systemic lupus erythematosus was made. The patient was treated with oral steroids and hydroxychloroquine.
Results
b) Systemic lupus erythematosus
Systemic lupus erythematosus is a chronic inflammatory autoimmune disease that has a wide variety of physical indications like neuropsychiatric manifestations. Systemic lupus erythematosus affects both men and women of all ages, but more commonly affects young females than males. Neuropsychiatric systemic lupus erythematosus is a set of neuropsychiatric signs and symptoms that occur secondary to the central nervous system involvement in patients with systemic lupus erythematosus during illness.
