Antinuclear antibodies testing as a routine screening for systemic lupus erythematosus in patients presenting first-episode psychosis

Early Interv Psychiatry. 2012 Aug;6(3):322-5. doi: 10.1111/j.1751-7893.2011.00339.x. Epub 2012 Jan 19.

Abstract

Aims: This report discusses the use of antinuclear antibody (ANA) detection as a screening test for neuropsychiatry systemic lupus erythematosus (NPSLE) in patients presenting a first-episode psychosis.

Methods: We reviewed the medical records of 85 patients admitted to an emergency service due to first-episode psychosis, during a 1-year period, for whom ANA detection was performed through an IFI HEp2 cell assay. ANA-positive patients were subsequently evaluated for autoantibodies and neuroimaging exams.

Results: Three patients presented as ANA positive in the initial screening and further investigation confirmed NPSLE in two patients. The patients were treated with antipsychotics and cyclophosphamide pulses with satisfactory outcomes.

Conclusion: Even though ANA detection is not specific, it is a low-cost procedure and could be an important screening test for NPSLE in the early-onset psychosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Antinuclear / analysis*
  • Antipsychotic Agents / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Diagnostic Tests, Routine / statistics & numerical data
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lupus Vasculitis, Central Nervous System / complications
  • Lupus Vasculitis, Central Nervous System / diagnosis*
  • Lupus Vasculitis, Central Nervous System / drug therapy
  • Lupus Vasculitis, Central Nervous System / psychology
  • Male
  • Middle Aged
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / drug therapy
  • Psychotic Disorders / etiology*
  • Retrospective Studies

Substances

  • Antibodies, Antinuclear
  • Antipsychotic Agents
  • Immunosuppressive Agents
  • Cyclophosphamide