Microscopic polyangiitis presenting as schizophrenia

Primary vasculitides can affect the central nervous system but the psychiatric manifestations are not well described. The hallmark of the disorder is an acute necrotizing inflammation of the vessel media with fibrinoid necrosis. We report a case of a 31-year-old man who had been treated for schizophrenia but was found to have vasculitides of the microscopic polyangiitis type and who improved on therapy with corticosteroids and immunosuppressive drugs. We would like to draw attention to this rare but important manifestation of vasculitis, and to the importance of its recognition.