Guillain barre syndrome as initial presentation of systemic lupus erythematosus

Abstract

Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by multiple organ involvement including the peripheral nervous system. Guillan- Barrè syndrome (GBS) has an established association with SLE as one of its neurologic manifestations. However, GBS as an initial manifestation of SLE is only sparingly reported in the literature.
Methods: We present a case of a 26 year old woman who was initially managed by neurology unit for GBS but subsequently developed body swelling, hypertension and polyarthritis. She was evaluated and managed by both rheumatology and nephrology units.
Results: Renal biopsy showed histological features of membranous nephropathy suggestive of stage V lupus nephritis. The patient responded well to high dose corticosteroid, intravenous cyclophosphamide and azathioprine.
Conclusion: This case highlights that GBS can be an initial presentation of SLE and the usefulness of immunosuppressants in the management of such cases.

Keywords: Guillan-Barrè syndrome, Systemic Lupus Erythematosus, Lupus Nephritis, Immunosuppressants