Psychiatric manifestations of neuro-lupus: A case report

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can affect the skin, joints, and internal organs. Among its manifestations, neuropsychiatric involvement, collectively referred to as neuro-lupus, is one of the most severe, including central and peripheral neurological syndromes, autonomic nervous system disorders, and psychiatric syndromes.

We report the case of a 14-year-old girl admitted for acute-onset agitation, auto- and hetero-aggressiveness, and visual and auditory hallucinations. The adolescent was hospitalized in the Neuropediatric and Neurometabolic Diseases Unit at Pediatric Department II of Rabat Children’s Hospital, and the diagnosis of neuro-lupus was established based on clinical and biological criteria. Her course was marked by significant clinical improvement under corticosteroid boluses.

The diagnosis of neuro-lupus relies on the exclusion of infectious, metabolic, endocrine, or drug-related causes, and on correlation with SLE immunological activity. Management involves corticosteroids, immunosuppressive agents, and in severe or refractory cases, treatments such as rituximab or plasmapheresis. Despite these therapies, relapses remain frequent, and some patients develop chronic psychotic disorders.