Systemic lupus erythematosus presenting as mania

Objective: Psychiatric manifestations of systemic lupus erythematosus (SLE) are well recognized but usually occur in the later stages of the illness, with organic syndromes being the most common. This case highlights the fact that SLE can present with mania. Method: Single case report. Results: A 32-year-old woman was admitted to hospital with her first manic illness. Physical examination and investigations revealed her to be suffering from SLE although this had not been previously diagnosed. Her physical and psychiatric symptoms settled rapidly following treatment with prednisolone and chlorpromazine. Conclusion: The case emphasizes the polymorphous manifestations of SLE and the importance of considering physical disorders in patients with a first episode of psychosis.