ArticleArchive of clinical cases2025
Psychosis-predominant neuropsychiatric lupus in a severely malnourished adolescent: a diagnostic challenge.
Article in Archive of clinical cases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Neuropsychiatric systemic lupus erythematosus (NPSLE) is a rare but severe manifestation of systemic lupus erythematosus in adolescents, with psychosis-predominant presentations occurring in approximately 5-12% of pediatric cases. Such manifestations may precede or obscure classic systemic features, often resulting in diagnostic delays and initial misattribution to primary psychiatric or infectious etiologies. We present the case of a previously healthy 19-year-old female who developed acute psychosis characterized by paranoia, auditory hallucinations, disorganization, and suicidal ideation over five days. Immunosuppressive therapy was initiated with pulse-dose methylprednisolone, followed by intravenous immunoglobulin and rituximab. Early consideration of autoimmune etiologies and a multidisciplinary approach, including rheumatology, psychiatry, neurology, and nutrition, are essential to optimize outcomes in this vulnerable population. The patient's limited psychiatric response despite immunologic improvement underscores the delicate balance between prompt immunosuppression and the neuropsychiatric risks associated with corticosteroid therapy. This case highlights the diagnostic challenges of psychosis-predominant NPSLE in adolescents complicated by nutritional and infectious factors, whilst emphasizing the importance of early recognition of autoimmune etiologies and multidisciplinary management for optimal outcomes.
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