A 35-year-old woman with SLE presents with confusion, seizures, and psychosis. MRI brain shows no structural lesion. CSF analysis is normal. Anti-ribosomal P antibody is positive. What is the most likely diagnosis?

• A Bacterial meningitis
• B Cerebral venous sinus thrombosis
• C Primary CNS vasculitis
• D Neuropsychiatric SLE (NPSLE) ✓

Explanation

Neuropsychiatric SLE encompasses a wide spectrum including seizures, psychosis, and cognitive dysfunction. Anti-ribosomal P antibody is specifically associated with NPSLE, particularly psychosis. Normal CSF and MRI exclude infection and structural lesions. CVST would occur in antiphospholipid syndrome and typically presents with headache and venous infarcts on imaging.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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