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MODERN RHEUMATOLOGY Vol.14 No.4

>MR14-4

A case of central nervous system lupus in succession to lupus peritonitis: a difficulty in the differential diagnosis between lupus psychosis and steroid-induced psychosis
Miki Murata1,2 , Akira Hashiramoto1,2, Toru Yamaguchi4, Chihiro Takabayashi2, Takashi Yamane2, Yasushi Miura1,2, Hisamitsu Baba2, 3, Kazuo Chihara4 and Shunichi Shiozawa1, 2

(1) Department of Rheumatology, Kobe University FHS School of Medicine, and Division of Bioregulation, Kobe University Graduate School of Medicine, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
(2) Present address: Rheumatic Disease Division, Kobe University Hospital, Kobe, Japan
(3) Department of Biosignal Pathology, Medical Center for Student Health, Kobe, Japan
(4) Division of Endocrinology/Metabolism, Neurology and Hematology/Oncology, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

Received: 06 December 2003 Accepted: 07 February 2004

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Abstract

A 55-year-old woman with well-controlled systemic lupus erythematosus (SLE) suffered from the abrupt onset of massive intractable ascites, which did not respond to conventional diuretic therapy. While treatment with methylprednisolone pulse therapy ameliorated this lupus peritonitis, neuropsychiatric symptoms then appeared. After a diagnosis of the central nervous system (CNS) lupus, pulse therapy was continued and the patient recovered from the lupus psychosis. We discuss the differential diagnosis between CNS lupus and steroid-induced psychosis with particular references to recent diagnostic methods for CNS lupus.
 
Key words
Central nervous system (CNS) lupus - Lupus peritonitis - Lupus psychosis - Steroid-induced spsychosis
 
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