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l�ll Psychosis due to systemic lupus erythematosus: characteristics and long-term outcome of this rare manifestation of the disease Pego-Reigosa JM; Isenberg DARheumatology (Oxford) 2008[Oct]; 47 (10): 1498-502OBJECTIVE: To determine the prevalence, characteristics and long-term outcome of psychosis due to SLE defined according to the ACR nomenclature for neuropsychiatric (NP) syndromes. METHODS: All the patients who strictly fulfilled the ACR definition for psychosis due to lupus were identified within the 485 patients of our lupus cohort and retrospectively evaluated. RESULTS: Psychosis due to lupus was diagnosed in 11 (2.3%) patients. Lupus psychosis presented as the initial presentation of SLE in 60% of the patients and within the first year of the disease in 80% of the cases. All the patients developed psychotic symptoms within the context of multi-systemic lupus activity, with 90% of them having cutaneous involvement. Psychosis activity in our patients was associated with biological markers of lupus activity in 90% of the cases. The aPLS were observed in 10% of the cases. Seventy percent of our patients showed complete resolution of psychotic symptoms after a mean follow-up of 155 months. Long-lasting remissions were seen in all those patients. Chronic mild psychotic symptoms were observed in 30% of our patients. CONCLUSION: Psychosis due to lupus is an uncommon event that usually occurs early in the course of the disease and is associated with other clinical and biological features of SLE. Long-term outcome appears to be favourable after intensive immunosuppressive treatment. This report highlights the need for prospective multi-centre studies to improve our knowledge and to help establish guidelines for the treatment of this rare complication of lupus.|Adolescent[MESH]|Adult[MESH]|Antipsychotic Agents/therapeutic use[MESH]|Cerebrovascular Circulation[MESH]|Drug Therapy, Combination[MESH]|Electroencephalography[MESH]|Female[MESH]|Glucocorticoids/therapeutic use[MESH]|Humans[MESH]|Immunosuppressive Agents/therapeutic use[MESH]|Lupus Vasculitis, Central Nervous System/drug therapy/physiopathology/*psychology[MESH]|Magnetic Resonance Imaging[MESH]|Male[MESH]|Prognosis[MESH]|Psychotic Disorders/drug therapy/*etiology/physiopathology[MESH]|Retrospective Studies[MESH]|Treatment Outcome[MESH] |