Factors predictive of corticosteroid psychosis in patients with SLE

Q: 34 years old female with a history of lupus and on home steroids is admitted to ICU with severe psychosis. Which of the following is a risk factor for glucocorticoid-induced psychosis in Systemic lupus erythematosus (SLE)? (select one)

A) Hyperalbuminemia

B) Hypoalbuminemia 

Answer: B

Psychosis in lupus is well-known. The most difficult part is to identify whether this psychosis is a direct manifestation of the disease itself or is due to the high glucocorticoid dose, prevalent for treatment in SLE. One of the underlying factors that may help to identify the cause of psychosis in this patient population is hypoalbuminemia, which may be a risk factor for glucocorticoid-induced psychosis in patients with SLE.

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#psychiatry

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#neurology

Reference:

Chau SY, Mok CC. Factors predictive of corticosteroid psychosis in patients with systemic lupus erythematosus. Neurology 2003; 61:104.