A Case of Acute Inflammatory Demyelinating Polyradiculoneuropathy in a Patient with Systemic Lupus Erythematosus

Jeong-Won Lee; Ji-Hyoun Kang; Hyoung-Ju Hong; Sun-Mi Ju; Kyung-Eun Lee; Lihui Wen; Dong-Jin Park; Tae-Jong Kim; Yong-Wook Park; Shin-Seok Lee

doi:10.4078/jrd.2014.21.3.143

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Lee, Kang, Hong, Ju, Lee, Wen, Park, Kim, Park, and Lee: A Case of Acute Inflammatory Demyelinating Polyradiculoneuropathy in a Patient with Systemic Lupus Erythematosus

Case Report

J Rheum Dis 2014;21(3):143-146.

Published online: 31 October 2014

DOI: https://doi.org/10.4078/jrd.2014.21.3.143

A Case of Acute Inflammatory Demyelinating Polyradiculoneuropathy in a Patient with Systemic Lupus Erythematosus

Jeong-Won Lee, Ji-Hyoun Kang, Hyoung-Ju Hong, Sun-Mi Ju, Kyung-Eun Lee, Lihui Wen, Dong-Jin Park, Tae-Jong Kim, Yong-Wook Park, Shin-Seok Lee

Department of Rheumatology, Chonnam National University Medical School, Gwangju, Korea

Corresponding to: Shin-Seok Lee, Department of Rheumatology, Chonnam National University Medical School, 42, Jebong-ro, Dong-gu, Gwangju 501-757, Korea. E-mail: shinseok@chonnam.ac.kr

Received 7 June 2013 Revised 24 June 2013 Accepted 26 June 2013

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Neuropsychiatric manifestations in patients with systemic lupus erythematosus are fairly common, with a prevalence of 37∼95%. Among 19 neuropsychiatric manifestations, acute inflammatory demyelinating polyradiculoneuropathy (AIDP) is quite rare, and is characterized by progressive, symmetric muscle weakness accompanied by absent or depressed deep tendon reflexes. Generally, plasma exchange and intravenous immunoglobulin are the main treatment modalities. Here, we report a case of AIDP in a 29-year-old SLE patient, who was fully recovered with a treatment of high-dose glucocorticoid and immunosuppressive agents. Ours case suggests that AIDP should be treated differently in SLE patients to avoid disastrous results.

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Keywords: Systemic lupus erythematosus, Central nervous system, Polyradiculoneuropathy

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Table 1.

The nerve conduction studies show absent F-waves in both arms and absent both H reflex

	F-Latency (ms)	Normal range (ms)	Left-Right F-Latency (ms)	Normal range (ms)
Left Median (Abd Poll Brev)		＜33		＜2.2
Right Median (Abd Poll Brev)		＜33		＜2.2
Left Peroneal (EDB)	45.58	＜60	1.92	＜5.1
Right Peroneal (EDB)	47.50	＜60	1.92	＜5.1
Left Tibial (Abd Hallucis)	45.58	＜61	1.75	＜5.7
Right Tibial (Abd Hallucis)	47.33	＜61	1.75	＜5.7
Left Ulnar (Abd Dig Min)		＜36		＜2.5
Right Ulnar (Abd Dig Min)		＜36		＜2.5

	H-Latency (ms)	Left-Right H-Latency (ms)	Normal range (ms)
Left Tibial (Gastrocnemius)			＜2.0
Right Tibial (Gastrocnemius)			＜2.0

ms: mili second, Abd Poll Brev: Abductor pollicis brevis, EDB: Extensor digitorum brevis, Abd Hallucis: Abductor Hallucis, Abd Dig Min: Abductor digiti minimi.

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