Neuropsychiatric Systemic Lupus Erythematosus: Making the Case for an Expanded Psychiatric Role

Systemic Lupus Erythematous can present with psychiatric symptoms. As these symptoms are non-specific and may occur in the absence of clear systemic signs and symptoms of lupus, they are difficult to distinguish from primary psychiatric illnesses. We present the case of a young woman who, on two separate admissions, was treated for a psychiatric illness with no effect and then treated for Neuropsychiatric SLE with remarkable improvement. We discuss the atypical features that a psychiatrist can use to distinguish the two diagnoses and the role of the psychiatrist or neurologist in determining the severity of mental status changes in order to guide treatment.