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Delirium and modified-release prednisone in an elderly woman with rheumatoid arthritis

  • Ciro Manzo
Case Report
  • 8 Downloads

Background

Delirium is an acute disturbance in attention and awareness, with fluctuating severity. A disturbance in cognition (e.g., memory deficit, disorientation, language, visual and spatial ability) represents an additional classification criterion. Alterations in sleep–wake cycle, perceptual disturbances, emotional lability, behavioral disturbances can be other supportive findings. According to the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5), there must be evidence from the history, physical examination or laboratory findings that all these disturbances are a direct consequence of: another medical condition, substance intoxication or withdrawal, exposure to a toxin, and multiple etiologies [1]. In its fulfillment, predisposing (e.g., severity of an acute illness, sensory impairment, dehydration, multimorbidity) and precipitating factors (e.g., malnutrition, bladder cathether, polypharmacy with prescription...

Keywords

Delirium Modified-release prednisone Rheumatoid arthritis Neuroinflammation 

Notes

Acknowledgements

The author thanks Dr. M. Papa, psychiatrist, and Dr. A. Mosca, general practitioner, for their precious collaboration.

Compliance with ethical standards

Conflict of interest

The author declares no conflict of interest.

Ethical approval

The author declares that the case report was carried out in compliance with the Helsinki declaration.

Informed consent

Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent may be requested from the author.

References

  1. 1.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, ArlingtonCrossRefGoogle Scholar
  2. 2.
    Clegg A, Young JB (2011) Review: insufficient evidence exists about which drugs are associated with delirium: benzodiazepines may increase risk. Ann Intern Med 154:JC6–J10PubMedCentralGoogle Scholar
  3. 3.
    Buttgereit F, Smolen JS, Coogan AN et al (2015) Clocking in: chronobiology in rheumatoid arthritis. Nat Rev Rheumatol 11:349–356CrossRefGoogle Scholar
  4. 4.
    de Rooij SE, van Munster BC, Korevaar JC et al (2007) Cytokines and acute phase response in delirium. J Psychosom Res 62:521–525CrossRefGoogle Scholar
  5. 5.
    Maldonado JR (2013) Neuropathogenesis of delirium: review of current etiologic theories and common pathways. Am J Geriatr Psychiatry 21:1190–1222CrossRefGoogle Scholar
  6. 6.
    Neufeld KJ, Yue J, Robinson YN et al (2016) Antipsychotic medication for prevention and treatment of delirium in hospitalized adults: a systematic review and meta-analysis. J Am Geriatr Soc 64:705–714CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Center for Cognitive Disease and Dementias, Pomigliano d’Arco, Azienda sanitaria locale Napoli 3 sudNaplesItaly
  2. 2.Rheumatologic Outpatient Clinic and Geriatric Rheumatologic Ambulatory, Sant’Agnello, Azienda sanitaria locale Napoli 3 sudNaplesItaly

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