A Limited Systemic Scleroderma Patient with Social Behavior Change and Role of Gut Microbiome: a Case Report

The role of the gut microbiome in influencing immune function and homeostasis is being investigated. A ۵۶-years-old female patient was referred due to nightmares, insomnia, pain, and redness in all her fingers. At first, Zolpidem was prescribed by a psychiatrist, but it induced a stuffy nose, change in behavior, drugged feeling, and tiredness. Previously she had been referred to a rheumatologist, and after some visits, atypical scleroderma had been diagnosed. She received psychiatric treatment with quetiapine and melatonin and was prescribed a probiotic diet. The patient was followed up and showed an excellent therapeutic response after augmentation with diet therapy. The treatment based on gut or fecal microbiome transplantation (FMT) may affect the patient's behavior and sleep disturbance. Thus the key point is the role of gut microbiota and FMT-based therapy in chronic rheumatic patients with resistance and refractory psychiatric symptoms, which improves the quality of life and acceptance of treatment.