Abstract
19 year old woman was admitted to our hospital because of the psychiatric manifestations. She was well until one month before entry, when schizophrenia like psychosis and disturbance of behavior developed. She was admitted another hospital and administered haloperidol without symptomatic improvement. She was referred to our hospital because of leukopenia and spastic seizures on August 10, 1989. On admission she was severely depressed and became frankly schizophrenic. Active synovitis in the small joints of hand and ankles, skin rash and fever were observed. Laboratory studies revealed leukopenia and positive antibodies against n-RNP which was detectable to a serum dilution of 1 in 128. Antibodies against neither ds-DNA nor Sm were detected. She was started on high dose methylprednisolone pulse therapy of three courses. After three months of maintenance steroids therapy, she was fully orientated and improved.
Enough items were present in criteria for systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD) in this patient, and it was suggested that the psychiatric manifestations may be one of the clinical signs of the patient with antibodies against n-RNP positive connective tissue disease and bolus methylprednisolone should be attempted for these patients as a therapy.
