Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Government Medical College, Calicut, India.
Rheumatol Int. 2022 Aug;42(8):1461-1476. doi: 10.1007/s00296-021-05006-y. Epub 2021 Sep 27.
Catatonia is a rare psychomotor syndrome characterized by stupor, posturing and echophenomena. It can be associated with schizophrenia, infections, drugs and autoimmune causes like anti N-methyl D-aspartate (NMDA) receptor encephalitis and systemic lupus erythematosus (SLE). Here we report two cases of systemic lupus erythematosus with catatonia, who improved with immunosuppressive treatment and review the cases described in the literature. The first case presented with fever, pancytopenia, toxic epidermal necrolysis (TEN)-like rash and later developed catatonia and macrophage activation syndrome (MAS). The second case presented with acute cutaneous lupus erythematosus (ACLE), fever, alopecia, polyarthralgias, nephritis, cytopenias along with catatonia. Successful management of this syndrome requires prompt recognition and treatment with immunosuppression as well as benzodiazepines with or without electroconvulsive therapy (ECT).
紧张症是一种罕见的精神运动综合征，其特征为昏迷、姿势异常和类幻听。它可能与精神分裂症、感染、药物和自身免疫性疾病有关，如抗 N-甲基-D-天冬氨酸（NMDA）受体脑炎和系统性红斑狼疮（SLE）。本文报告了两例狼疮性紧张症患者，他们的病情在免疫抑制治疗后得到改善，并回顾了文献中描述的病例。第一个病例表现为发热、全血细胞减少、中毒性表皮坏死松解症（TEN）样皮疹，随后出现紧张症和巨噬细胞活化综合征（MAS）。第二个病例表现为急性皮肤型狼疮（ACLE）、发热、脱发、多发性关节痛、肾炎、血细胞减少，同时伴有紧张症。这种综合征的成功治疗需要及时识别和免疫抑制治疗，以及苯二氮䓬类药物，有或没有电惊厥治疗（ECT）。
