title: Psychotic episodes in an elderly woman with an anticentromere-positive scleroderma variant, IgA deficiency, and hypothyroidism.
abstract: A 66-year-old woman presented with a recurrent psychotic disorder with central manifestations that initially suggested a delusional disorder. Peripheral stiffness was at first attributed to a dystonic reaction secondary to neuroleptic treatment. The atypical presentation led to suspicion of collagen vascular disease. Both the psychotic disorder and peripheral involvement responded to cortisone. Findings are discussed in light of recent information on the pathogenesis and neuropsychiatric manifestations of systemic lupus erythematosus, progressive systemic scleroderma and limited scleroderma variants (CREST, unclassifiable connective tissue disease) with positive anticentromere titers, including a discussion of the vasculitis hypothesis of collagen vascular cerebral involvement.
authors.affiliation: Veterans Administration Medical Center, Providence, RI.
authors.forename: A H
authors.initials: AH
authors.lastname: Schmid
authors.forename: B R
authors.initials: BR
authors.lastname: Meltzer
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003240:Connective Tissue Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications*; D017098:IgA Deficiency / Q000276:immunology; D026741:Physical Therapy Modalities; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D011241:Prednisone