Neuropsychiatric manifestations as the beginning of systemic lupus erythematosus. Case report

Abstract

Introduction: systemic lupus erythematosus (SLE) is a chronic autoimmune disease that frequently presents with neuropsychiatric manifestations. The diversity and severity of these symptoms vary widely and can occur in both the early and advanced stages of the disease, complicating its diagnosis and differentiation.

Clinical Case: a 19-year-old male, native of Guayaquil, with no medical history except for frequent and self-limited mouth ulcers, came to the clinic due to delirium, confusion and seizures, without infectious symptoms. Brain resonance imaging was performed with and without contrast, showing an increase in signal intensity in the bilateral medial temporal regions that partially included the left insular cortex, suggestive of encephalitis, with ANA antibodies in high titers and decreased C4 complement, both in the blood, compatible with SLE with neuropsychiatric manifestations.

Conclusion: SLE can affect the central nervous system through neuropsychiatric manifestations. Diagnosis is based on clinical evaluation, laboratory tests, and imaging studies. Early diagnosis is essential to initiate timely treatment and improve disease prognosis.