Could autoimmune diseases be at the root of some mental illnesses? Sander Markx, director of precision psychiatry at Columbia University, thinks so. “By all accounts, she was thriving, in overall good health and showing no signs of mental distress beyond the normal teenage growing pains,” they said of April Burrell. This was before she suffered a traumatic experience, became incoherent, and was hospitalized. Twenty years after she became catatonic, Markx discovered that April’s bloodwork showed antibodies were attacking her brain. Miraculously, after several courses of steroids and immunosuppressive drugs, April improved to the point where in 2020, she was deemed mentally competent enough to check herself out of treatment, but not before a joyful reunion with her family.

The medical team set to work counteracting April’s rampaging immune system and started April on an intensive immunotherapy treatment for neuropsychiatric lupus. Every month for six months, April would receive short, but powerful “pulses” of intravenous steroids for five days, plus a single dose of cyclophosphamide, a heavy-duty immunosuppressive drug typically used in chemotherapy and borrowed from the field of oncology. She was also treated with rituximab, a drug initially developed for lymphoma.

The regimen is grueling, requiring a month-long break between each of the six rounds to allow the immune system to recover. But April started showing signs of improvement almost immediately.

A video of the reunion shows that April was still tentative and fragile. But her family said she remembered her childhood home in Baltimore, the grades she got in school, being a bridesmaid in her brother’s wedding — seemingly everything up until when the autoimmune inflammatory processes began affecting her brain. She even recognized her niece, whom April had only seen as a small child, now a grown young woman. When her father hopped on a video call, April remarked “Oh, you lost your hair,” and burst out laughing, Guy Burrell recalled.

The family felt as if they’d witnessed a miracle.