An Unusual Presentation of Systemic Lupus Erythematosus with Vasculitic Polyneuropathy
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2019, Vol 6, Issue 11
Abstract
We report a case of systemic lupus erythematosus (SLE), in a 48-year-old woman, a known hypertensive and recently diagnosed diabetic, with a predominant complain of acute onset bilateral lower limb weakness and loss of sensation of the bilateral palm and soles with bowel incontinence and excessive hair loss. On evaluation, her vitals were stable, cardiovascular, respiratory, and abdominal systemic examination revealed no significant abnormality. Neurological examination revealed a normal tone with distal muscle weakness more in the lower limb than in the upper limb. She was thoroughly evaluated for the above-mentioned complaints and examination findings. Nerve conduction study was done - which revealed upper limb - severe asymmetric motor sensory neuropathy - axonal type and lower limb - axonal symmetrical severe polyradiculoneuropathy. Nerve biopsy revealed a vasculitic neuropathy. Autoimmune workup was positive for antinuclear antibodies, and low C3 levels, with direct Coombs test positive, increased UPCR ratio. According to the Systemic Lupus International Collaborating Clinic criteria, she was diagnosed with SLE. Hence, this is a case of SLE, with a primary presentation of a vasculitic neuropathy, an unusual occurrence.
Authors and Affiliations
Shruthi Muralidharan, K Arun, Subramaniyan Kumarasamy, v Ruckmani
Keywords
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