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Steroid induced psychosis in systemic lupus erythematosus: a possible role of serum albumin level
  1. F López-Medrano,
  2. R Cervera,
  3. O Trejo,
  4. J Font,
  5. M Ingelmo
  1. Department of Autoimmune Diseases, Institut Clínic d'Infeccions i Immunologia, Hospital Clínic, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Catalonia, Spain
  1. Correspondence to:
    Dr R Cervera, Servei de Malalties Autoimmunes, Hospital Clínic, Villarroel 170, 08036-Barcelona, Catalonia, Spain;
    rcervera{at}clinic.ub.es

https://doi.org/10.1136/ard.61.6.562

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    Steroids may have diverse and sometimes severe adverse effects in the short and long term.1 We present three patients with systemic lupus erythematosus (SLE)2 and steroid induced psychosis (table 1), emphasising the importance that serum albumin levels may have on the development of this complication.

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    Table 1

    Main clinical features of three patients with SLE and steroid induced psychosis

    CASE REPORTS

    Case 1

    Patient No 1 is a 20 year old woman with SLE diagnosed five years ago, in whom a serum albumin level of 24 g/l and proteinuria of 3.2 g/l were detected in routine tests. Diffuse proliferative lupus nephritis was diagnosed by renal biopsy and she was treated with one pulse of cyclophosphamide (500 mg) and oral prednisone (60 mg/day). Three days later she developed anxiety, insomnia, euphoria, verbosity, grandiosity, and megalomaniac ideas. She was treated with oral risperidone (2 mg/12 h), oral …

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    Footnotes

    • F López-Medrano is currently at Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain.