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Catatonia in Systemic Lupus Erythematosus.

Ciro Manzo1, Jordi Serra-Mestres2, Marco Isetta3

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Catatonia is a rare but significant manifestation of Systemic Lupus Erythematosus (SLE), often appearing early in young patients. Treatment with lorazepam and electroconvulsive therapy generally leads to favorable outcomes.

Keywords:
anti-phosholipid antibodiesanti-ribosomal P protein antibodiesautoimmune encephalitisbenzodiazepinescatatoniaelectroconvulsive therapynarrative reviewneuropsychiatric systemic lupus erythematosussystemic lupus erythematosus

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Area of Science:

  • Rheumatology
  • Psychiatry
  • Neurology

Background:

  • Systemic lupus erythematosus (SLE) is linked to catatonia, though reports are infrequent.
  • A comprehensive understanding of catatonia in SLE patients is lacking.
  • This review aims to consolidate existing literature on catatonia in SLE.

Purpose of the Study:

  • To identify all published reports of catatonia in SLE patients.
  • To comprehensively analyze the clinical characteristics of catatonia in SLE.
  • To provide practical insights for clinical management.

Main Methods:

  • Conducted comprehensive literature searches across major databases (MEDLINE, EMBASE, PsycINFO, PubMed).
  • Utilized combined controlled and free-text search terms for SLE and catatonia.
  • Focused on case reports and series, with manual citation tracking for additional references.

Main Results:

  • Identified 39 cases of SLE with catatonia (mean age 22.64 years; 35 females).
  • Catatonia occurred at SLE onset in 10 patients and within one month of diagnosis in 5.
  • Most patients improved with lorazepam and/or electroconvulsive therapy; malignant catatonia was rare.

Conclusions:

  • Catatonia can be an initial presentation of SLE, particularly in younger individuals.
  • The prognosis for catatonia in SLE patients is generally favorable.
  • Early recognition and treatment are crucial for positive outcomes.