When April Burrell was 21, she went from being an outgoing college student to being institutionalized with a diagnosis of severe schizophrenia. For 26 years, she was unreachable. She didn't recognize her own family. She couldn't take care of herself. Every available treatment failed her. Then Dr. Anthony Zoghbi, a research fellow at Columbia University at the time, came across her case, dug into her chart, and found something others had missed. She had markers of autoimmunity.
A team of doctors worked together to come up with a new treatment plan that included intravenous steroids, a chemotherapy drug, and an immunotherapy medication used to treat lymphoma. With her family's blessing, they tried it.
After a series of treatments, April began to recognize her family. She could engage in conversation. Her psychosis disappeared.
April had returned.
Her doctors now believe that for more than a quarter of a century, April Burrell had been suffering from neuropsychiatric lupus. She had treatable autoimmune encephalitis. Her immune system had been attacking her brain.
Burrell's case is at the heart of a growing scientific debate: how many of the 23 million people worldwide living with schizophrenia may be suffering from autoimmune encephalitis, in which brain inflammation can cause confusion, cognitive decline, and psychosis? Dr. Anthony Zoghbi, an assistant professor at Baylor College of Medicine, is among the researchers working urgently to find out.
Zoghbi's team is studying patients at Houston's Ben Taub Hospital, screening blood samples for antibodies that may be targeting brain proteins. They're searching for a biological test that could identify who among the diagnosed schizophrenia population might actually respond to immune-based treatments. Researchers have already linked more than twenty antibodies to psychiatric symptoms, and Zoghbi estimates that between one and five percent of schizophrenia patients may have treatable autoimmune conditions. That's potentially more than a million people.
The emerging field of immunopsychiatry may have implications well beyond schizophrenia, with researchers exploring possible autoimmune links to bipolar disorder, PTSD, OCD, and depression. But as Zoghbi acknowledges, the science moves slowly. He told TPR's Bonnie Petrie that he sometimes feels like he's in a race against time for those who may be suffering needlessly with a treatable condition.
Guest: Anthony Zoghbi, M.D., assistant professor and chief of Neuropsychiatric Genetics in the departments of psychiatry and human molecular genetics at Baylor College of Medicine
