Systemic lupus erythematosus with acute inflammatory demyelinating polyneuropathy: a case report

Abstract

We recently managed a case of acute inflammatory demyelinating polyneuropathy associated with SLE. A 20-year-old newly diagnosed SLE patient presented with a three-week history of acute bilateral ascending weakness associated with inability to walk. Physical examination revealed muscle strength in the legs with graded 2/5 proximally and 2/5 distally bilaterally and absence of deep tendon reflex in both knees and ankles. The muscle strength in upper limb was 3/5 proximally and 3/5 distally bilaterally. Paresthesia was observed in distal limbs with glove and stocking distribution. Cerebrospinal fluid analysis was normal. Electrophysiologic survey indicated asymmetrical mixed sensory motor demyelination and radiculopathy. The diagnosis of SLE was established based on her initial symptoms including fevers, fatigue, malar rash, myalgia, and positive ANA. Treatment with intravenous immunoglobulin and methylprednisolone resulted in clinical improvement.

Keywords: Systemic lupus erythematosus, Acute inflammatory demyelinating polyneuropathy, Guillain-Barre syndrome