Electroconvulsive therapy for catatonia in juvenile neuropsychiatric lupus.
Neuropsychiatric manifestations are serious and frequent complications of systemic lupus erythematous (SLE). Catatonia is a neuropsychiatric disorder characterized by motor disturbance (including waxy flexibility and catalepsy), stupor, excitement, negativism, mutism, echopraxia and echolalia. Catatonia associated with SLE has been only rarely reported, especially in children. Here we present a case of a 14-year-old patient encountered in consultation-liaison psychiatry who presented catatonia associated with SLE. Her catatonia was refractory to treatment with pulse methylprednisolone, intravenous cyclophosphamide and rituximab. The patient responded to a combined therapy of electroconvulsive therapy and benzodiazepines. The present case suggests that although rarely reported, catatonia seen in the background of SLE should be promptly identified and treated to reduce the morbidity.
Section of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Department of Psychiatry, Faculty of Medicine, Pontifícia Universidad Católica de Chile, Chile.
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Leon
Section of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Department of Psychiatry, Faculty of Medicine, Pontifícia Universidad Católica de Chile, Chile.
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Aguirre
Section of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Department of Psychiatry, Faculty of Medicine, Pontifícia Universidad Católica de Chile, Chile.
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Pesce
Section of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Department of Psychiatry, Faculty of Medicine, Pontifícia Universidad Católica de Chile, Chile.
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Sanhueza
Section of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Department of Psychiatry, Faculty of Medicine, Pontifícia Universidad Católica de Chile, Chile ptoro@uc.cl.
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Toro
D000293:Adolescent; D001569:Benzodiazepines / Q000627:therapeutic use; D002389:Catatonia / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
D001569:Benzodiazepines
ECT; Neuropsychiatric lupus; catatonia; systemic lupus erythematosus