Course of Neuropsychiatric Symptoms during Flares ofSystemic Lupus Erythematosus (SLE )

We present the case of a seventeen-year-old girl who presents with an interesting course of neuropsychiatric symptoms duringseveral flares of SLE. The patient was diagnosed at the age of thirteen and has had four flares in total. The latter two flaresincluded cutaneous and neuropsychiatric symptoms. The most recent flare occurred when she was aged seventeen. She hadcutaneous symptoms which coincided with an episode of hypomania. Her mental state further deteriorated following steroidtreatment. She exhibited affective and psychotic symptoms. Treatment with cyclophosphamide and olanzapine was associatedwith an improvement in both cutaneous and neuropsychiatric symptoms. Previously aged sixteen the patient had presented withcutaneous symptoms and a moderate depressive episode which was also exacerbated by steroid treatment. The patient’s moodimproved when the dose of oral steroids was reduced to a daily dose of 15–20 mg prednisolone