{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T06:47:27Z","timestamp":1783838847613,"version":"3.55.0"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Catatonia is a rare neuropsychiatric syndrome that has been exceptionally described as the initial manifestation of systemic lupus erythematosus (SLE). We report the case of a 32-year-old woman who presented with severe catatonia, autoimmune hemolytic anemia, and lupus hepatitis as the first expression of SLE. Positive ANA, anti-SM, and anti-ribosomal P antibodies, elevated anti-dsDNA with low complement, and a SLEDAI-2\u00a0K score of 8 supported the diagnosis. Antiphospholipid antibodies were negative. The patient received high-dose corticosteroids, cyclophosphamide, hydroxychloroquine, and lorazepam, with marked improvement after three days and complete recovery within two weeks, remaining relapse-free during follow-up. This case emphasizes the importance of considering catatonia as an initial manifestation of neuropsychiatric SLE and highlights the diagnostic relevance of anti-ribosomal P antibodies in such presentations.<\/jats:p>","DOI":"10.1093\/omcr\/omaf249","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T12:00:15Z","timestamp":1761307215000},"source":"Crossref","is-referenced-by-count":2,"title":["Catatonia as the initial manifestation of neuropsychiatric lupus"],"prefix":"10.1093","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9099-3936","authenticated-orcid":false,"given":"Abihai","family":"Lucas-Hern\u00e1ndez","sequence":"first","affiliation":[{"name":"Rheumatology department, Hospital General de Teziutl\u00e1n, IMSS-BIENESTAR. Calle Bugambilias #7, Teziutl\u00e1n , Puebla 73960 ,","place":["M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2990-9890","authenticated-orcid":false,"given":"Blanca Estela","family":"Hern\u00e1ndez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Faculty of medicine, Benem\u00e9rita Universidad Aut\u00f3noma de Puebla , Calle 13 Sur 2702, Puebla, Puebla, 72420 ,","place":["M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1228-7671","authenticated-orcid":false,"given":"Alexis","family":"Rojas-Xicoht\u00e9ncatl","sequence":"additional","affiliation":[{"name":"Faculty of medicine, Benem\u00e9rita Universidad Aut\u00f3noma de Puebla , Calle 13 Sur 2702, Puebla, Puebla, 72420 ,","place":["M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8829-3511","authenticated-orcid":false,"given":"Juan Manuel","family":"Lucas-Lerdo","sequence":"additional","affiliation":[{"name":"Faculty of medicine, Benem\u00e9rita Universidad Aut\u00f3noma de Puebla , Calle 13 Sur 2702, Puebla, Puebla, 72420 ,","place":["M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5891-361X","authenticated-orcid":false,"given":"Zurisadahi","family":"Hern\u00e1ndez-Barre","sequence":"additional","affiliation":[{"name":"Faculty of medicine, Benem\u00e9rita Universidad Aut\u00f3noma de Puebla , Calle 13 Sur 2702, Puebla, Puebla, 72420 ,","place":["M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6735-0070","authenticated-orcid":false,"given":"Ana Lilia","family":"Peralta-Amaro","sequence":"additional","affiliation":[{"name":"Division of Postgraduate Studies, Universidad Nacional Autonoma de Mexico, Escolar 411A, Copilco Universidad, Coyoac\u00e1n, Ciudad de \u00a0 , 04510, M\u00e9xico","place":["Mexico"]},{"name":"Internal Medicine Department, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro M\u00e9dico Nacional \u201cLa Raza\u201d, Instituto Mexicano del Seguro Social , Seris y Zaachila S\/N, Colonia La Raza, Ciudad de M\u00e9xico, 02990,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"2025112607522922600_ref1","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.reuma.2013.02.007","article-title":"Neuropsychiatric manifestations in systemic lupus erythematosus: physiopathogenic and therapeutic basis","volume":"9","author":"Aguilera-Pickens","year":"2013","journal-title":"Reumatol Clin"},{"key":"2025112607522922600_ref2","doi-asserted-by":"publisher","first-page":"6670","DOI":"10.3390\/jcm11226670","article-title":"Plasmapheresis for a patient with catatonia and systemic lupus erythematosus: a case report and literature review","volume":"11","author":"Tsai","year":"2022","journal-title":"J Clin Med"},{"key":"2025112607522922600_ref3","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.psym.2018.06.007","article-title":"Catatonia associated with systemic lupus erythematosus (SLE): a report of two cases and a review of the literature","volume":"59","author":"Boeke","year":"2018","journal-title":"Psychosomatics."},{"key":"2025112607522922600_ref4","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1002\/art.21539","article-title":"Accuracy of anti-ribosomal P protein antibody testing for the diagnosis of neuropsychiatric systemic lupus erythematosus: an international meta-analysis","volume":"54","author":"Karassa","year":"2006","journal-title":"Arthritis Rheum"},{"key":"2025112607522922600_ref5","first-page":"985","article-title":"Neuropsychiatric manifestations in systemic lupus erythematosus: prevalence and association with antiphospholipid antibodies","volume":"30","author":"Sanna","year":"2003","journal-title":"J Rheumatol"},{"key":"2025112607522922600_ref6","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1177\/0961203313486951","article-title":"Catatonia in systemic lupus erythematosus: a case report and review of literature","volume":"22","author":"Grover","year":"2013","journal-title":"Lupus."}],"container-title":["Oxford Medical Case 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