Neuropsychiatric systemic lupus erythematosus manifest as bipolar affective disorder: a case report

Abstract

Background: Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disorder that affects multiple systems of the body, including the central nervous system. in the neuropsychiatric Systemic lupus erythematosus are the consequences of severe SLE activity, and can develop into mood disorder.

Methods: This is a case study.

Results: We are reporting a case of a 43-years-old patient with SLE who in a state of hypomania after long observation of suspecting the affective bipolar disorder, had a history of depression and manic episodes at the time. The internist gave a symptomatic treatment for the SLE symptoms and the psychiatrist gave an antidepressant, monitoring primary effects, and medication adherence.  To maintain Bipolar affective disorder (BD)  in SLE we apply watchful medication. Because if SLE was controlled, the BD symptoms would be improved.

Conclusion: Bipolar disorder is related to SLE due to neurotransmitter imbalance and down-regulation of inhibitory control in the emotional circuitry, leading to mood state oscillations. Our SLE patient also consumed corticosteroids, which may down-regulate brain-derived neurotrophic factor, contributing to mood disorders. To manage BD in SLE, we use watchful waiting for high-dose corticosteroid treatment or start tapering off the dosage, as controlling SLE improves BD symptoms.