title: The use of electroconvulsive therapy in a patient with juvenile systemic lupus erythematosus and catatonia.
abstract: Catatonia is a rare manifestation in patients with systemic lupus erythematosus (SLE). As catatonia can be associated with both psychiatric and organic conditions, this could create a diagnostic dilemma once this occurs in SLE patients. The report describes a 15-year-old female with SLE who developed catatonia three days after the diagnosis of SLE was made. Her catatonia was refractory to the treatment with immunosuppressive therapy, which included pulse methylprednisolone, intravenous cyclophosphamide, rituximab, intravenous immunoglobulin (IVIG) and plasmapheresis. Given her persistent catatonia, electroconvulsive therapy (ECT) was initiated three months after the onset of her symptoms. After the third ECT treatment, her mental status dramatically improved and returned nearly to baseline while she was continued on the immunosuppression. This is the first report of a successful ECT therapy in catatonic lupus in children.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: T
authors.initials: T
authors.lastname: Mon
authors.forename: S
authors.initials: S
authors.lastname: L'ecuyer
authors.forename: N B
authors.initials: NB
authors.lastname: Farber
authors.forename: A J
authors.initials: AJ
authors.lastname: White
authors.forename: K W
authors.initials: KW
authors.lastname: Baszis
authors.forename: J K
authors.initials: JK
authors.lastname: Hearn
authors.forename: T E
authors.initials: TE
authors.lastname: Spiegel
authors.forename: A R
authors.initials: AR
authors.lastname: French
authors.forename: M
authors.initials: M
authors.lastname: Kitcharoensakkul
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002389:Catatonia / Q000209:etiology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D020945:Lupus Vasculitis, Central Nervous System / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents