Medical case narrative
A 21-year-old told she had schizophrenia and bipolar disorder — her labs said lupus
What happened
A 21-year-old Black woman was initially diagnosed with schizophrenia and bipolar disorder during an acute psychotic episode. The case report's own title carries that first diagnosis.
What it looked like
Acute psychosis and agitation — treated along the way with rotating doses of quetiapine, haloperidol, lorazepam, and midazolam.
What the labs found
Her ANA came back at 1:2560 — an extremely high antinuclear antibody titre — with anti-double-stranded DNA at 1:80 and a low complement C3 of 77 mg/dL. The picture was neuropsychiatric lupus: her immune system involving her brain.
What changed
Three days of high-dose IV methylprednisolone (1 g a day) led to resolution of her acute psychosis and agitation, per the report. She was also started on hydroxychloroquine and received cyclophosphamide at discharge — so this was a full lupus treatment plan, not steroids alone.
The test that told the story
ANA with anti-dsDNA and complement (C3/C4) testing.
Sources: Case report, PubMed Central (PMC9580603); Henry Ford ScholarlyCommons repository version of the same article.