title: Catatonia as the presenting symptom in systemic lupus erythematosus.
abstract: Catatonia is a syndrome of physical and behavioral abnormalities that can result from psychiatric, neurological, or medical illness. Although systemic lupus erythematosus (SLE) is commonly known to cause neurological and psychiatric manifestations, it has only rarely been reported to cause the catatonic syndrome. In nearly all previously reported cases, the diagnosis of catatonia was reported in patients with an established diagnosis of lupus. We report a case in which a woman with no known medical history presented with catatonia that did not respond to standard treatment with benzodiazepines, suffered a long and complicated hospital course, and was eventually diagnosed with lupus. With initiation of treatment for lupus, her symptoms of catatonia remitted. This case illustrates the importance of considering medical causes in the diagnosis and treatment of psychiatric disorders, especially the catatonic syndrome.
authors.affiliation: Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Pustilnik
authors.forename: Alexandru
authors.initials: A
authors.lastname: Trutia
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000974:Antibodies, Antinuclear / Q000097:blood; D018501:Antirheumatic Agents / Q000008:administration & dosage; D002389:Catatonia / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006760:Hospitalization; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage*; D007902:Length of Stay; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage*; D011602:Psychophysiologic Disorders; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000974:Antibodies, Antinuclear; D018501:Antirheumatic Agents; D006886:Hydroxychloroquine; D011241:Prednisone