Neuropsychiatric Manifstation in Patient Having SLE

Abstract

A 30 year old woman residing at Khargaon, M.P., presented with complaints of abnormal behavior, decreased sleep, unable to perform routine activity and headache in psychiatry OPD of Dhiraj General Hospital. She was referred to medicine OPD for the complaints of fever and skin rash. On examination, she had terminal neck rigidity and brisk deep reflexes but normal plantar reflexes. On investigation she had pancytopenia with normal CT brain and CSF examination. ANA was positive. She had four positive criteria as per American college of Rheumatology Classification of SLE (updated in 1997) and thus diagnosis of SLE was made. On higher mental state examination she had poor affect, mood swings, delusions and poor judgment. Her orientation was normal. Memory and cognition appeared normal however it was difficult to test it as she did not co-operate. Patient was treated with steroid and immunosuppressive therapy and showed improvement. This suggests the importance of neurological and psychiatric examination in case of SLE.