A case is reported in which an exacerbation of systemic lupus erythematosus presented as an organic depressive disorder with psychotic features. Brain imaging using regional cerebral blood flow techniques demonstrated vascular dysregulation in the left frontal lobe of this patient. The implications for understanding the pathogenesis of psychiatric disorders in lupus are discussed.
References
1.
DenburgJ.A., TemesvariP.The pathogenesis of neuropsychiatrie lupus.Can Med Assoc J1983; 128: 257–269.
2.
PinchingA.J., TraversR.L., HughesG.R.V.Oxygen-15 brain scanning for detection of cerebral involvement in systemic lupus erythematosus.Lancet1978; i: 898–900.
3.
BresnihanB., HohmeisterR., CuttingJ.The neuropsychiatrie disorder in systemic lupus erythematosus: evidence for both vascular and immune mechanisms.Ann Rheum Dis1979; 38: 301–306.
4.
KushnerM.J., ChawlukJ., FazekasF.Cerebral blood flow in systemic lupus erythematosus with or without cerebral complications.Neurology1987; 37: 1596–1598.
5.
ProhovnikI., KnudsenE., RisbergJ.Theoretical evaluation and simulation test of the initial slope index for non-invasive rCBF. In: HartmannA., HoyerS., eds. Cerebral blood flow and metabolism measurement.New York: Springer-Verlag,1985: 56–60.
6.
ProhovnikI.Regional cerebral blood flow (rCBF) in psychiatry: methodological issues. In: MorihisaJ., ed. Brain imaging in psychiatry.Washington: American Psychiatric Press,1984.
7.
MaximilianV.A., ProhovnikI., RisbergJ.Cerebral hemodynamic response to mental activation in normo- and hypercapnia.Stroke1980; 11: 342–347.
8.
StarksteinS.E., RobinsonR.G., PriceT.R.Comparison of cortical and subcortical lesions in the production of poststroke mood disorders.Brain1987; 110: 1045–1059.
9.
EllisS.G., VerityM.A.Central nervous system involvement in systemic lupus erythematosus: a review of neuropathologic findings in 57 cases, 1955–1977.Semin Arthritis Rheum1979; 8: 212–221.
