Mixed Connective Tissue Disease Presenting With Psychosis-A Case Report.

IF 1.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Nervous and Mental Disease Pub Date : 2024-04-01 DOI:10.1097/NMD.0000000000001767

Nikhil Tondehal, Arnab Sengupta, Kavya Mohankumar, Chintan Trivedi, Zeeshan Mansuri, Shailesh Jain

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Abstract

Abstract: Mixed connective tissue disease (MCTD) is a systemic autoimmune disease with features overlapping multiple autoimmune disorders. One study found that over 55% of patients with MCTD experienced neuropsychiatric symptoms, the most common of which was an "aseptic meningitis-like syndrome." We present a case of a 17-year-old adolescent girl presenting with abnormal speech and behavior, auditory hallucinations, and paranoid delusions after an isolated episode of fever. She was treated for her psychotic symptoms but later developed symptoms resembling neuroleptic malignant syndrome. An antibody screen revealed elevated anti-U1-ribonucleoprotein antibodies with a possible diagnosis of MCTD. She finally responded to steroid therapy. To our knowledge, this is the first reported case of MCTD initially presenting with psychosis. A diagnosis of autoimmune disorders should be kept in the differential of similar clinical presentations including connective tissue disorders and autoimmune thyroid conditions.

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混合性结缔组织病伴有精神病--病例报告

摘要：混合结缔组织病（MCTD）是一种全身性自身免疫性疾病，其特征与多种自身免疫性疾病重叠。一项研究发现，超过 55% 的混合结缔组织病患者会出现神经精神症状，其中最常见的是 "无菌性脑膜炎样综合征"。我们介绍了一例 17 岁少女的病例，她在一次孤立的发热后出现了言语和行为异常、幻听和偏执性妄想。她的精神症状得到了治疗，但后来又出现了类似神经性恶性综合征的症状。抗体筛查显示抗 U1 核糖核蛋白抗体升高，可能诊断为 MCTD。她最终对类固醇治疗产生了反应。据我们所知，这是首例最初表现为精神病的 MCTD 病例。在鉴别类似的临床表现（包括结缔组织病和自身免疫性甲状腺疾病）时，应注意自身免疫性疾病的诊断。

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来源期刊

Journal of Nervous and Mental Disease 医学-精神病学

CiteScore

2.90

自引率

5.30%

发文量

233

审稿时长

3-8 weeks

期刊介绍： The Journal of Nervous and Mental Disease publishes peer-reviewed articles containing new data or ways of reorganizing established knowledge relevant to understanding and modifying human behavior, especially that defined as impaired or diseased, and the context, applications and effects of that knowledge. Our policy is summarized by the slogan, "Behavioral science for clinical practice." We consider articles that include at least one behavioral variable, clear definition of study populations, and replicable research designs. Authors should use the active voice and first person whenever possible.