Table 2.
Documented cases
| Patient | Presentation | Laboratories | Imaging | Initial Treatment | References |
|---|---|---|---|---|---|
| Female, 77 years ‐old (Present Case) | Mystical religious delusions, psychomotor agitation, verbal and physical aggression |
Anticardiolipin IgG 112, IgM 116 ANA 1/160 Rheumatoid factor <12 C‐reactive protein: 3.48 C3: 0.57 C4: 0.1 |
Brain MRI showing cortico‐subcortical atrophy of frontotemporal predominance, compensatory ventriculomegaly, focal hyperintense subcortical lesions in frontal lobe and periventricular area, <1 cm in diameter, consistent with small‐vessel disease | Clonazepam, quetiapine, memantine, and donepezil | NA |
| Female, 49 years old | Persecutory delusions, reactive anxiety, and low mood. No signs of autoimmune disease | Lymphopenia, ANA 1/1280, dsDNA antibodies 1/60. RF, and ANTI‐ENA negative. CRP, ESR, and complement were normal | Brain MRI showing multiple hyperintensities in the subcortical white matter of the frontal and parietal lobes | Atypical neuroleptics | 20 |
| Female, 15 years old | Fever, dizziness, trouble speaking, blurred vision. Followed by dysphoria, delusions, and edema | Thrombocytopenia 40 x 109/L, hypocomplementemia, positive ANA of 1:100, positive anti‐Rib‐p, anti‐SSA, and positive Coomb's test. APTT 89.7s. Positive anticardiolipin IgG, anti‐b2 IgG, and IgM | Brain MRI showing hemorrhage of the left frontotemporal lobe, right parietal lobe, right temporal lobe, and right cerebellar hemisphere; and thrombosis of the sagittal sinus and right transverse sinus | Methylprednisolone, quetiapine, and mannitol | 21 |
| Female, 47 years old | Persecutory delusions, delusions of reference, unveiling delusions, delusions of stealing ideas, and delusions of complex and bizarre substance accompanied by illusory and hallucinatory sensations | ANA 1:320, hypocomplementemia, thrombocytopenia | Brain MRI showing bilateral hyperintensities on T1‐weighted images and hypointensities on T2‐weighted images in the basal ganglia. T2 and FLAIR images showing hyperintensities in the subcortical white matter | Haloperidol for 4 years, followed by aripiprazole and flupentixol | 22 |
| Female, 50 years old | Schizophrenia‐like syndrome | Positive serological test for syphilis and positive Wassermann reaction, ANA 1:10.24, Rho‐positive antibodies present, anticardiolipin antibodies increased 33 U/mL (normal <10) for IgG, 17 U/mL (normal <6) for IgM | Brain CT showing infarction and foci of calcification | Corticoids, azathioprine, argininosuccinate synthetase, and haloperidol | 23 |