Catatonia secundária ao lúpus eritematoso sistêmico: Revisão sistemática
DOI:
https://doi.org/10.33448/rsd-v11i11.33412Palavras-chave:
Catatonia; Lúpus eritematoso sistêmico; Neuropsiquiatria.Resumo
Lúpus Eritematoso Sistêmico (LES) é uma doença autoimune que é conhecido por estar associado a manifestações neuropsiquiátricas com uma prevalência de 17 a 75% nos portadores da doença. A catatonia tem sido descrita no espectro clínico das manifestações neuropsiquiátricas (MNP) do LES. O objetivo desse estudo foi caracterizar, por meio de uma revisão sistemática, as manifestações clínicas e a terapêutica da catatonia induzida por Lúpus Eritematoso Sistêmico (LES). Foi realizado uma revisão sistemática de relato e série de casos utilizando os descritores “Systemic Lupus Erythematosus” e “Catatonia”, no período de 1977 a 2021, nas bases de dados Medline©, PubMed©, Lilacs©, Scielo© e EMBASE© publicados em Espanhol, Francês, Inglês e Português. De um total de 50 pacientes analisados nos estudos selecionados, cerca de 54% tinham idade entre 18 e 35 anos, com prevalência total no sexo feminino, 90%. Evidenciou-se que o quadro clínico é bem variado com predominância de mutismo (75%), imobilidade/estupor (55%), rigidez (40%) e flexibilidade cérea (40%). 46% dos pacientes apresentaram alterações do sistema nervoso central detectado através da ressonância magnética de cérebro, tomografia computadorizada de crânio, eletroencefalograma ou punção lombar. Em relação ao tratamento proposto a cada paciente, com descrição de melhora, tem-se o uso de benzodiazepínicos, eletroconvulsoterapia, glicocorticoides e imunossupressores como responsáveis por quase todas as respostas de resolutividade. Conclui-se que os transtornos psiquiátricos não são bem descritos no LES. Este estudo evidencia a importância do diagnóstico e tratamento de transtornos psiquiátricos, especialmente a síndrome catatônica. LES deve, portanto, ser incluído no diagnóstico diferencial de pacientes apresentando a síndrome catatônica.
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