Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Feb 19, 2025; 15(2): 102259
Published online Feb 19, 2025. doi: 10.5498/wjp.v15.i2.102259
Catatonia induced by antipsychotics in an adolescent male patient with systemic lupus erythematosus: A case report
Wen-Qi Geng, Xiao-Xi Yang, Jin-Ya Cao, Jing Wei
Wen-Qi Geng, Jin-Ya Cao, Jing Wei, Department of Psychological Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing 100730, China
Xiao-Xi Yang, Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
Xiao-Xi Yang, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, Beijing 100730, China
Xiao-Xi Yang, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing 100730, China
Xiao-Xi Yang, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100730, China
Co-first authors: Wen-Qi Geng and Xiao-Xi Yang.
Co-corresponding authors: Jin-Ya Cao and Jing Wei.
Author contributions: Geng WQ conceptualized, did formal analysis, validated, and wrote the paper; Yang XX conceptualized, did formal analysis, validated, and wrote the paper; Cao JY conceptualized, investigated, supervised, performed project administration, and wrote the paper; Wei J conceptualized, supervised, performed project administration, acquired funding, and wrote the paper. Geng WQ and Yang XX contributed equally to this work as co-first authors. The rationale for having two co-corresponding authors are as follows: During the writing process of this article, both corresponding authors provided professional guidance and put forward suggestions for original drafts and following revisions, which was considered equal contributions.
Supported by STI2030-Major Projects, No. 2021ZD0202001; and Capital Funds for Health Improvement and Research, No. CFH 2022-2-4012.
Informed consent statement: Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.
Conflict-of-interest statement: The other author(s) declare no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Ya Cao, MD, Assistant Professor, Department of Psychological Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. caojinya@pumch.cn
Received: October 13, 2024
Revised: December 7, 2024
Accepted: December 20, 2024
Published online: February 19, 2025
Processing time: 93 Days and 0.9 Hours
Abstract
BACKGROUND

Systemic lupus erythematosus (SLE) can affect multiple organs or systems. The involvement of the central nervous system can result in the manifestation of epilepsy, an acute confusional state, and other rare neuropsychiatric presentations, such as catatonia.

CASE SUMMARY

We present a case of an adolescent male patient with first-onset SLE who presented with neuropsychiatric symptoms including epilepsy and delirium. The initial utilization of olanzapine to alleviate symptoms of agitation precipitated the emergence of catatonia, which was mitigated by discontinuing olanzapine and supplementing with lorazepam. In this case, whether the catatonia was secondary to the utilization of antipsychotics or to an organic disease is a question that warrants differential diagnosis.

CONCLUSION

Multidisciplinary collaborative management is the cornerstone for the successful management of severe cases of SLE.

Keywords: Catatonia; Systemic lupus erythematosus; Referral consultation; Antipsychotics; Benzodiazepines; Case report

Core Tip: Neuropsychiatric systemic lupus erythematosus (SLE) includes a variety of neurological and psychiatric features, whereas SLE is an underlying medical condition linked to catatonia, a potentially life-threatening neuropsychiatric condition. We present a case of an adolescent male patient with SLE who presented with neuropsychiatric symptoms including seizures and delirium, and who subsequently developed catatonia, independent of SLE, due to the use of antipsychotics. To our knowledge, this is the first documented case report of an adolescent patients with SLE who presented with catatonia secondary to the use of antipsychotics.