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Chronic Schizophrenia Comorbid with Neuropsychiatric Systemic Lupus Erythematosus

Chun-Ya Kuo, Huai-Hsuan Tseng, Yen-Wen Wu, Mei-Fang Cheng, Pin-Hao Chen, Song-Chou Hsieh, Chih-Min Liu

Background: The neuropsychiatric events are frequently encountered in patients
with systemic lupus erythematosus (SLE). The psychotic symptoms and
cognitive dysfunctions are relatively common in SLE with central nervous system
(CNS) involvement. Case Report: We present a patient with SLE with CNS involvement,
who has also carried a diagnosis of schizophrenia for nine years. The
presentation of progressive cognitive impairment suggested the diagnosis of SLE
with CNS involvement. The result of the neuropsychological assessment showed
great improvement after a six-month immunosuppressant therapy, especially in the
dimensions of verbal and visual memory. The brain perfusion scan also showed the
fi nding of remarkable improvement after treatment. Conclusion: This case shows
the differences and complex presentations in psychopathology, neuropsychological
tests, and brain imaging in those two diseases. Clinicians should be alert for
considering other organic causes for progressive cognitive impairments in the
course of chronic schizophrenia.
Key Word neuropsychiatric systemic lupus erythematosus, schizophrenia, central nervous system involvement, cognitive impairment
Editorial Committe, Taiwanese Journal of Psychiatry
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