Lupus Cerebritis Refractory to Guideline-Directed Therapy: A Case Report
Systemic lupus erythematosus is an autoimmune disease that affects multiple organs and organ systems, subsequently requiring an elaborate regimen for management. We present the case of a 63-year-old female who developed unrelenting symptoms of drug-induced lupus, which persisted even after the offen...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2021-04-01
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| Series: | Journal of Investigative Medicine High Impact Case Reports |
| Online Access: | https://doi.org/10.1177/23247096211008708 |
| _version_ | 1818361646084521984 |
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| author | Suman Rao MD Akhila Sunkara MBBS Ashwini Ashwath MBBS Nimisha Srivastava MBBS Emily Albert MD, MPH |
| author_facet | Suman Rao MD Akhila Sunkara MBBS Ashwini Ashwath MBBS Nimisha Srivastava MBBS Emily Albert MD, MPH |
| author_sort | Suman Rao MD |
| collection | DOAJ |
| description | Systemic lupus erythematosus is an autoimmune disease that affects multiple organs and organ systems, subsequently requiring an elaborate regimen for management. We present the case of a 63-year-old female who developed unrelenting symptoms of drug-induced lupus, which persisted even after the offending agent was withdrawn, unmasking her underlying systemic lupus erythematosus. She continued to develop neuropsychiatric symptoms, including mania and hallucinations, which complicated the management of her disease. After exhausting the bank of anti-inflammatory and immunomodulators recommended by current guidelines, we found that a combination of rituximab infusions with thiothixene, an antipsychotic agent, significantly improved our patient’s neuropsychiatric symptoms. Further research should be conducted to determine the efficacy of rituximab in the treatment of resistant lupus cerebritis, and to validate the use of thiothixene in the management of neuropsychiatric symptoms secondary to lupus. |
| first_indexed | 2024-12-13T21:19:59Z |
| format | Article |
| id | doaj.art-87c12e4242d3490d941cbda69a9feb3a |
| institution | Directory Open Access Journal |
| issn | 2324-7096 |
| language | English |
| last_indexed | 2024-12-13T21:19:59Z |
| publishDate | 2021-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Investigative Medicine High Impact Case Reports |
| spelling | doaj.art-87c12e4242d3490d941cbda69a9feb3a2022-12-21T23:31:08ZengSAGE PublishingJournal of Investigative Medicine High Impact Case Reports2324-70962021-04-01910.1177/23247096211008708Lupus Cerebritis Refractory to Guideline-Directed Therapy: A Case ReportSuman Rao MD0Akhila Sunkara MBBS1Ashwini Ashwath MBBS2Nimisha Srivastava MBBS3Emily Albert MD, MPH4SUNY Upstate Medical University, Syracuse, NY, USASUNY Upstate Medical University, Syracuse, NY, USASUNY Upstate Medical University, Syracuse, NY, USASUNY Upstate Medical University, Syracuse, NY, USASUNY Upstate Medical University, Syracuse, NY, USASystemic lupus erythematosus is an autoimmune disease that affects multiple organs and organ systems, subsequently requiring an elaborate regimen for management. We present the case of a 63-year-old female who developed unrelenting symptoms of drug-induced lupus, which persisted even after the offending agent was withdrawn, unmasking her underlying systemic lupus erythematosus. She continued to develop neuropsychiatric symptoms, including mania and hallucinations, which complicated the management of her disease. After exhausting the bank of anti-inflammatory and immunomodulators recommended by current guidelines, we found that a combination of rituximab infusions with thiothixene, an antipsychotic agent, significantly improved our patient’s neuropsychiatric symptoms. Further research should be conducted to determine the efficacy of rituximab in the treatment of resistant lupus cerebritis, and to validate the use of thiothixene in the management of neuropsychiatric symptoms secondary to lupus.https://doi.org/10.1177/23247096211008708 |
| spellingShingle | Suman Rao MD Akhila Sunkara MBBS Ashwini Ashwath MBBS Nimisha Srivastava MBBS Emily Albert MD, MPH Lupus Cerebritis Refractory to Guideline-Directed Therapy: A Case Report Journal of Investigative Medicine High Impact Case Reports |
| title | Lupus Cerebritis Refractory to Guideline-Directed Therapy: A Case Report |
| title_full | Lupus Cerebritis Refractory to Guideline-Directed Therapy: A Case Report |
| title_fullStr | Lupus Cerebritis Refractory to Guideline-Directed Therapy: A Case Report |
| title_full_unstemmed | Lupus Cerebritis Refractory to Guideline-Directed Therapy: A Case Report |
| title_short | Lupus Cerebritis Refractory to Guideline-Directed Therapy: A Case Report |
| title_sort | lupus cerebritis refractory to guideline directed therapy a case report |
| url | https://doi.org/10.1177/23247096211008708 |
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