Chronic psychiatric illness masquerading as bipolar disorder in a family secondary to familial systemic lupus erythematosus with limbic encephalitis

Manorenj, Sandhya; Shaik, Reshma Sultana

doi:10.4103/indianjpsychiatry.indianjpsychiatry_178_21

Cited by 2 publications

(7 citation statements)

References 4 publications

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“…The authors observed a spectrum of neurological and psychiatric manifestations such as changes in consciousness, behavioral disturbances, seizures, disorientation, hallucinations, and movement disorders that correspond with the results of EEG and MRI (Angst et al, 2015;Asmaa et al, 2022;Kano et al, 2009;Kelley et al, 2018;Li et al, 2022;Manorenj and Shaik, 2021;Muñoz et al, 2017;Raventhiranathan et al, 2022;Selcuk et al, 2011;Stubgen et al, 1998;Sugi et al, 2018;Tsuchiya et al, 2021;Yamaguchi et al, 2012;Zhang et al, 2021). These neurological deficits encompass a variety of symptoms, including cognitive impairments such as attention deficits, memory deficits, and aphasia, movement disorders such as dystonia, dyskinesia, gait changes, seizures, pseudobulbar affect, delusions, and auditory and visual hallucinations.…”

Section: Neurological and Psychiatric Manifestationsmentioning

confidence: 65%

“…In another case, the patient was initially diagnosed with bipolar disorder. However, after a thorough investigation, it was confirmed that the patient had SLE with limbic encephalitis and bipolar-like manifestations (Manorenj and Shaik, 2021).…”

Section: Initial Encephalitis and Sle-related Presentationmentioning

confidence: 96%

“…These neurological deficits encompass a variety of symptoms, including cognitive impairments such as attention deficits, memory deficits, and aphasia, movement disorders such as dystonia, dyskinesia, gait changes, seizures, pseudobulbar affect, delusions, and auditory and visual hallucinations. Mood disturbances were identified in one case (Angst et al, 2015;Asmaa et al, 2022;Kano et al, 2009;Kelley et al, 2018;Li et al, 2022;Manorenj and Shaik, 2021;Muñoz et al, 2017;Raventhiranathan et al, 2022;Selcuk et al, 2011;Stubgen et al, 1998;Sugi et al, 2018;Tsuchiya et al, 2021;Yamaguchi et al, 2012;Zhang et al, 2021). Several cases exhibited prolonged epileptic seizures during the course of the disease, with a few cases experiencing comorbidities.…”

Section: Neurological and Psychiatric Manifestationsmentioning

confidence: 99%

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Neurological complexity in systemic lupus erythematosus: insights into autoimmune encephalitis

Liana Halim,

Novia Putri

2023

SMJ IDI Surabaya

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Background: Autoimmune encephalitis (AE) is an inflammatory syndrome characterized by autoantibodies targeting the central nervous system (CNS), leading to a wide range of neurological and psychiatric manifestations. Objective: This systematic review aims to investigate the coexistence of AE and systemic lupus erythematosus (SLE) to shed light on potential underlying mechanisms. Materials and Methods: Following PRISMA guidelines, a comprehensive search was conducted using Boolean logic in research databases i.e., PubMed, ProQuest, ScienceDirect, and Web of Science to identify relevant studies on AE, SLE, and their potential correlation. After the initial screening, exclusion, and quality assessment using the Joanna Briggs Institute Critical Appraisal Checklist, 14 studies were included for analysis. Among 18 patients, 88.9% were female whose an average age was 31.9 ± 12.7 years. Clinical presentations were varied, including cognitive impairment (66.67%), seizures (61.1%), altered mental status (50%), and movement disorders. Neuroimaging and neurophysiological findings consistently aligned with encephalitis, with MRI abnormalities observed in 94.4% of cases. Various autoantibodies were identified, including anti-NMDAR, anti-AMPA-R2, and anti-GluR antibodies. Conclusion: The identification of neuronal antibodies is crucial, particularly in scenarios involving both neuropsychiatric SLE (NPSLE) and encephalitis. This investigation aims to reveal etiological insights. The ongoing debate revolves around whether SLE-related encephalitis is associated with NPSLE through SLE antibodies or involves distinct antibodies. Further clinical research is essential to clarify the pathogenic role of autoantibody in SLE-linked AE.

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Section: Neurological and Psychiatric Manifestationsmentioning

confidence: 65%

Section: Initial Encephalitis and Sle-related Presentationmentioning

confidence: 96%

Section: Neurological and Psychiatric Manifestationsmentioning

confidence: 99%

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Neurological complexity in systemic lupus erythematosus: insights into autoimmune encephalitis

Liana Halim,

Novia Putri

2023

SMJ IDI Surabaya

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“…It is estimated that BD occurs in approximately 6% of SLE patients [52]. There are also case reports in the literature indicating the possibility of lupus disguised as bipolar disorder [53,54]. Treatment of bipolar disorder in SLE is difficult because the substances used to control the autoimmune process often affect patients' mood.…”

Section: Mood Disordersmentioning

confidence: 99%

“…Szacuje się, że ChAD występuje u około 6% pacjentów z SLE [52]. W literaturze obecne są również opisy przypadków wskazujących na możliwość występowania tocznia pod maską choroby afektywnej dwubiegunowej [53,54]. Leczenie choroby afektywnej dwubiegunowej w przebiegu SLE jest utrudnione, ponieważ substancje stosowane do kontroli procesu autoimmunologicznego często wpływają na nastrój pacjentów.…”

Section: Zaburzenia Nastrojuunclassified

Patients with a rheumatological diagnosis in a psychiatrist's office - neuropsychiatric lupus

Szarpak,

Tomasik,

Stanicki

et al. 2024

Curr Probl Psychiatry

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Introduction: Systemic lupus erythematosus is an autoimmune disease affecting up to 210 per 100,000 people in Europe, more often among women. The inflammatory process in lupus causes changes in various organs. However, somatic changes are not the only effects of lupus. The neuropsychiatric manifestations of this disease have been given a separate name – neuropsychiatric lupus. Material and methods: A review of the literature available on the PubMed platform in the period of 1987-2023 was performed using the key words: neuropsychiatric systemic lupus erythematosus, mental disorders, mood disorders, sleep disorders, systemic lupus erythematosus. Original studies, review works, meta-analyses and Internet sources were analyzed. Results: Psychotic disorders in lupus occur with a frequency of up to 3%. Risk factors include young age, male gender and glucocorticoids treatment. Mood disorders occur in several to several dozen percent of lupus patients, including depression affecting up to ⅓ of patients. Belimumab, psychotherapy and improving the quality of sleep, the disturbance of which is observed in most patients with lupus, have potential in treatment. Anxiety disorders are seen primarily in the teenage age group, where social phobia predominates – the fear of rejection due to the disease – and they worsen and are exacerbated by rheumatic disease. Cognitive dysfunctions occur in up to 80% of lupus patients. They are probably related to enzymes of metabolic pathways, dyslipidemia and thyroid dysfunction. Conclusions: Mental disorders develop more often in patients with lupus than in the general population and they predispose to autoimmune diseases. Comprehensive diagnosis and psychiatric care of patients with lupus are necessary. Keywords: systemic lupus erythematosus, sleep disorders, mood disorders, neuropsychiatric systemic lupus erythematosus, mental disorders

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Chronic psychiatric illness masquerading as bipolar disorder in a family secondary to familial systemic lupus erythematosus with limbic encephalitis

Cited by 2 publications

References 4 publications

Neurological complexity in systemic lupus erythematosus: insights into autoimmune encephalitis

Neurological complexity in systemic lupus erythematosus: insights into autoimmune encephalitis

Patients with a rheumatological diagnosis in a psychiatrist's office - neuropsychiatric lupus

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