Psychosis with mania in patient with lupus using corticosteroids, a diagnostic challenge

Background: systemic lupus erythematosus is a chronic, autoimmune and multisystemic disease that can present neuropsychiatric manifestations, which represent a diagnostic challenge because it requires to differentiate if they are secondary to the pathology itself or adverse effects of the pharmacoth...

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Main Authors: Illiane Marie Pritsiolas Vernaza, Larissa Anette Calvo García
Format: Article
Language:Spanish
Published: Universidad de Ciencias Médicas de Camagüey 2018-06-01
Series:Archivo Médico de Camagüey
Subjects:
Online Access:http://www.revistaamc.sld.cu/index.php/amc/article/view/5501
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author Illiane Marie Pritsiolas Vernaza
Larissa Anette Calvo García
author_facet Illiane Marie Pritsiolas Vernaza
Larissa Anette Calvo García
author_sort Illiane Marie Pritsiolas Vernaza
collection DOAJ
description Background: systemic lupus erythematosus is a chronic, autoimmune and multisystemic disease that can present neuropsychiatric manifestations, which represent a diagnostic challenge because it requires to differentiate if they are secondary to the pathology itself or adverse effects of the pharmacotherapeutic treatment. Objective: to establish a differential diagnostic of psychosis on a patient with systemic lupus erythematosus. Clinical case: a 24 year-old female with past medical history of systemic lupus erythematosus, who was admitted to nephrology ward for recurrence of nephrotic syndrome. Prednisone dose was abruptly increased as part of the management given to the patient. After the discharge, the patient presented an episode of psychosis with mania. She was admitted to psychiatry service for a multidisciplinary management with nephrology and rheumatology, and lupic activity was discarded, therefore the patient was treated as a corticosteroid induced psychosis that responded to second generation antipsychotic. Conclusions: it is important for physicians to learn how to distinguish between lupus neuropsychiatric manifestations and those secondary to medical adverse effects in order to make an appropriate clinical approach. DeCS: PSYCHOTIC DISORDERS; ADRENAL CORTEX HORMONES; LUPUS ERYTHEMATOSUS, SYSTEMIC; ADULT; CASE REPORTS.
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spelling doaj.art-2643b5ae7a944614a44de243432b3bb52022-12-22T00:52:19ZspaUniversidad de Ciencias Médicas de CamagüeyArchivo Médico de Camagüey1025-02552018-06-012233363401957Psychosis with mania in patient with lupus using corticosteroids, a diagnostic challengeIlliane Marie Pritsiolas Vernaza0Larissa Anette Calvo GarcíaActualmente laboro en clínica privada. Formación en la Universidad de Panamá y en la Caja del Seguro Social de Panamá.Background: systemic lupus erythematosus is a chronic, autoimmune and multisystemic disease that can present neuropsychiatric manifestations, which represent a diagnostic challenge because it requires to differentiate if they are secondary to the pathology itself or adverse effects of the pharmacotherapeutic treatment. Objective: to establish a differential diagnostic of psychosis on a patient with systemic lupus erythematosus. Clinical case: a 24 year-old female with past medical history of systemic lupus erythematosus, who was admitted to nephrology ward for recurrence of nephrotic syndrome. Prednisone dose was abruptly increased as part of the management given to the patient. After the discharge, the patient presented an episode of psychosis with mania. She was admitted to psychiatry service for a multidisciplinary management with nephrology and rheumatology, and lupic activity was discarded, therefore the patient was treated as a corticosteroid induced psychosis that responded to second generation antipsychotic. Conclusions: it is important for physicians to learn how to distinguish between lupus neuropsychiatric manifestations and those secondary to medical adverse effects in order to make an appropriate clinical approach. DeCS: PSYCHOTIC DISORDERS; ADRENAL CORTEX HORMONES; LUPUS ERYTHEMATOSUS, SYSTEMIC; ADULT; CASE REPORTS.http://www.revistaamc.sld.cu/index.php/amc/article/view/5501psicosiscorticoideslupus eritematoso sistémicorisperidonaprednisona.
spellingShingle Illiane Marie Pritsiolas Vernaza
Larissa Anette Calvo García
Psychosis with mania in patient with lupus using corticosteroids, a diagnostic challenge
Archivo Médico de Camagüey
psicosis
corticoides
lupus eritematoso sistémico
risperidona
prednisona.
title Psychosis with mania in patient with lupus using corticosteroids, a diagnostic challenge
title_full Psychosis with mania in patient with lupus using corticosteroids, a diagnostic challenge
title_fullStr Psychosis with mania in patient with lupus using corticosteroids, a diagnostic challenge
title_full_unstemmed Psychosis with mania in patient with lupus using corticosteroids, a diagnostic challenge
title_short Psychosis with mania in patient with lupus using corticosteroids, a diagnostic challenge
title_sort psychosis with mania in patient with lupus using corticosteroids a diagnostic challenge
topic psicosis
corticoides
lupus eritematoso sistémico
risperidona
prednisona.
url http://www.revistaamc.sld.cu/index.php/amc/article/view/5501
work_keys_str_mv AT illianemariepritsiolasvernaza psychosiswithmaniainpatientwithlupususingcorticosteroidsadiagnosticchallenge
AT larissaanettecalvogarcia psychosiswithmaniainpatientwithlupususingcorticosteroidsadiagnosticchallenge