Case report Psychiatric manifestations in a patient after surgical management of aortic stenosis of systemic lupus erythematosus Andrzej Banyś1, Jakub Kaźmierski2, Ryszard Jaszewski3 1Department of Anaesthesiology and Intensive Cardiological Care, 1st Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland 2Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Poland 3Department of Cardiac Surgery, 1st Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland Submitted: 10 May 2010 Accepted: 29 July 2010 Arch Med Sci 2011; 7, 2: 342-344 DOI: 10.5114/aoms.2011.22089 Copyright © 2011 Termedia & Banach A b s t r a c t Systemic lupus erythematosus is a chronic inflammatory autoimmune disease which damages tissue and organs. Circulation, kidney, lungs, liver, central and peripheral nervous systems, joints and skin may be damaged. It also often involves psychotic syndromes which might even be stimulated by glucocorticoid therapy. In the following article we present the case report of psychotic symptoms in a 26-year old patient after management of aortic stenosis in systemic lupus erythematosus receiving glucocorticoid therapy. Key words: systemic lupus erythematosus, aortic stenosis surgery, psychotic symptoms. Introduction Neuropsychiatric symptoms in systemic lupus erythematosus (SLE) are observed in 15-75% of patients [1, 2]. They might arise at any time during the disease course. The first attempts of classification of neuropsychiatric symptoms in SLE were undertaken by Kassan and Lockshin in 1979 [3]. In 1999 an interdisciplinary team of consultants appointed by the American College of Rheumatology (ACR) Committee on Research worked out a uniform, standardized classification of neurological and psychiatric syndromes observed in patients with SLE, after excluding other causes of these disorders [4]. The study remains an acknowledged, obligatory canon of recognizing neuropsychiatric symptoms appearing in SLE. Case report A 26-year-old patient with SLE, during permanent immunosuppressive therapy, with hypertension under pharmacological control, lupus nephropathy treated since 1999, and a complex aortic valve disease in the form of bicuspid aortic valve stenosis with a gradient and incompetence IA I/II°, was admitted to the Cardiac Surgery Department in order to operate on the heart disease. On the day of admission (21.07.2009) the patient was in a good general condition, with no pain complaints, traits Corresponding author: Andrzej Banyś MD, PhD Department of Anaesthesiology and Intensive Cardiological Care 1st Chair of Cardiology and Cardiac Surgery Medical University of Lodz 1/3 Sterlinga 91-428 Lodz, Poland E-mail: andrzej.banys@umed.lodz.pl