REVIEW ARTICLEOpen Access

Management of Psychosis in Neuropsychiatric Lupus

Di Kang

http://orcid.org/0000-0003-0954-981X

Department of Medicine, Tuen Mun Hospital, Hong Kong SAR, China

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and

Chi Chiu Mok

Department of Medicine, Tuen Mun Hospital, Hong Kong SAR, China

E-mail Address: [email protected]

Corresponding author: C. C. Mok, Department of Medicine, Tuen Mun Hospital, Tsing Chung Koon Rd, Tuen Mun, Hong Kong.

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https://doi.org/10.1142/S2661341719300015Cited by:3 (Source: Crossref)

Abstract

Manifestations of neuropsychiatric systemic lupus erythematosus (NPSLE) are heterogeneous. Acute psychosis is an uncommon but well-recognized manifestation of NPSLE. With no specific biomarkers to date, the diagnosis of NPSLE relies on clinical acumen for circumstantial evidence and exclusion of important differential diagnoses. The attribution of psychosis to NPSLE is facilitated by the application attribution models. In particular, the American College of Rheumatology nomenclature, Systemic Lupus International Collaborating Clinics attribution models and Italian algorithm for the attribution of psychosis to NPSLE are revisited. The mainstay of treatment for psychosis attributable to NPSLE is immunosuppression and symptomatic control. In refractory cases, immunomodulatory and emerging biological agents may be considered. This article reviews the diagnostic dilemma, pathogenic mechanisms and treatment of psychosis in SLE patients.

Keywords:

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