PReS-FINAL-2308: Catatonia due to systemic lupus erythematosus: characteristics and 36 months follow up of this rare manifestation of disease

Methods We describe a 15,5 y old girl presented with fever and abdominal pain in June 2009. Patient had numerous scleronodous skin lesions, developed 20 months ago, treated as localized scleroderma in another center. She rapidly developed malar rash, periungval erythema, extreme conjunctival injection, photophobia, soft palate erosions, pericardial effusion, mild vaginal bleeding, intraarticular effusion, became excitable, moody, malaise, accompanied with positive immunoserology. Signs of incomplete macrophage activation syndrome were present (like feritin 162 098, exc.). Diagnosed as SLE, peroral steroids started. Afebrile in next 24 hours, cheerful, with good general condition. On therapy day 13., dramatic qualitative change of conscious level with psychomotor disturbance (resembling extrapyramidal symptomatology), fear, visual hallucinations, followed by tachycardia and hypertension. Organic catatonia and mutism developed. Brain CT, MRI, MRA were normal. Received pulses of metil-prednisolone and cyclophosphamide, IVIG, hydroxiquinolon-sulphat, aspirin, bensodiasepins, supportive therapy.