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Mixed Connective Tissue Disease Presenting With Psychosis-A Case Report
Nikhil Tondehal1, Arnab Sengupta2, Kavya Mohankumar3
1Mount Sinai, Beth Israel, New York.
The Journal of Nervous and Mental Disease
|March 27, 2024
Summary
This case study highlights a 17-year-old with psychosis and neuroleptic malignant syndrome, ultimately diagnosed with mixed connective tissue disease (MCTD). Early consideration of autoimmune disorders is crucial for similar presentations.
Area of Science:
- Neurology
- Rheumatology
- Psychiatry
Background:
- Mixed connective tissue disease (MCTD) is a systemic autoimmune disorder with overlapping features of other autoimmune conditions.
- Neuropsychiatric symptoms affect over 55% of MCTD patients, often presenting as aseptic meningitis-like syndrome.
Observation:
- A 17-year-old female presented with acute psychosis, including abnormal speech, behavior, auditory hallucinations, and paranoid delusions following a fever.
- She later developed symptoms consistent with neuroleptic malignant syndrome despite initial treatment for psychosis.
Findings:
- Elevated anti-U1-ribonucleoprotein antibodies were detected, leading to a diagnosis of MCTD.
- The patient showed significant improvement with steroid therapy.
Implications:
- This is the first reported case of MCTD initially presenting with psychosis.
- Autoimmune disorders, including MCTD and autoimmune thyroid conditions, should be considered in the differential diagnosis of unexplained psychosis and neurological symptoms.
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