Lupus cerebritis and steroid psychosis in mixed connective tissue disorder.

Neuropsychiatric disease may occur commonly in mixed connective tissue disorder (MCTD) and has been observed in up to 55 percent of patients. Aseptic meningitis has been described as the most common presentation, although psychosis, convulsions, peripheral neuropathy, trigeminal neuropathy, and cerebellar ataxia have also been described [1, 2]. Corticosteroid therapy is highly effective in the management of CNS and systemic MCTD but may independently cause mood disturbances and psychosis; therefore, clinicians must carefully distinguish this entity from primary CNS disease [35]. Lupus cerebritis and steroid psychosis occurring in patients with systemic lupus erythematosus (SLE) has been reported [6] but has not previously been described in mixed connective tissue disorder. Herein we describe an individual with MCTD demonstrating both CNS MCTD and steroid-induced psychosis over two consecutive hospitalizations. CASE REPORT