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Catatonia in systemic lupus erythematosus: case based review
T G Sundaram1, Hafis Muhammed1,2,3, Latika Gupta1
1Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Rheumatology International
|September 28, 2021
Summary
Catatonia, a rare psychomotor syndrome, can be an early sign of systemic lupus erythematosus (SLE). Prompt immunosuppressive treatment alongside benzodiazepines or electroconvulsive therapy (ECT) is crucial for managing SLE-associated catatonia.
Area of Science:
- Neurology
- Rheumatology
- Psychiatry
Background:
- Catatonia is a complex psychomotor syndrome with diverse etiologies.
- Autoimmune conditions, including anti-NMDA receptor encephalitis and systemic lupus erythematosus (SLE), are recognized causes.
- The presentation of catatonia in SLE requires further investigation.
Purpose of the Study:
- To report two cases of catatonia associated with systemic lupus erythematosus (SLE).
- To review existing literature on SLE-related catatonia.
- To highlight effective management strategies for this rare presentation.
Main Methods:
- Case report of two patients with SLE and catatonia.
- Literature review of previously described cases.
- Analysis of treatment responses, including immunosuppression, benzodiazepines, and electroconvulsive therapy (ECT).
Main Results:
- Two distinct cases of SLE presenting with catatonia are detailed.
- Case 1: Fever, pancytopenia, toxic epidermal necrolysis (TEN)-like rash, catatonia, and macrophage activation syndrome (MAS).
- Case 2: Acute cutaneous lupus erythematosus (ACLE), fever, alopecia, polyarthralgias, nephritis, cytopenias, and catatonia. Both cases showed improvement with immunosuppressive therapy.
Conclusions:
- Catatonia can be a presenting or associated feature of systemic lupus erythematosus (SLE).
- Early recognition and prompt treatment with immunosuppression are vital.
- A multimodal treatment approach including benzodiazepines and/or electroconvulsive therapy (ECT) is recommended for optimal outcomes.
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