Journal List > J Rheum Dis > v.19(5) > 1063989

Jung, Kim, Joo, Won, Koh, Park, Kwak, Choi, Kim, and Suh: Guillain-Barre Syndrome, Antiphospholipid Syndrome and Lupus Nephritis as Initial Manifestation of Systemic Lupus Erythematosus

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease with various manifestations, while its autoantibodies and immune reactions involve multiple organs. Neuropsychiatric involvement in SLE is known to be common, however, peripheral neuropathy is relatively rare. Guillain-Barre syndrome is clinically defined as an acute demyelinating peripheral neuropathy causing weakness and numbness in the legs and arms. We describe a case of Guillain-Barre syndrome with antiphospholipid syndrome and lupus nephritis. The patient was admitted with fever and diarrhea. He developed progressive weakness of the upper and lower extremities and dysarthria with characteristic nerve conduction patterns compatible with Guillain-Barre syndrome. He also had proteinuria and gangrene of the hand and toe with antiphospholipid antibody. He received intravenous immunoglobulin and plasmapheresis for progressive neuropathy, intravenous high dose steroid to control activity of SLE, and anticoagulation for antiphospholipid syndrome. Neuropsychiatric manifestation of SLE is related to lupus activity closely, so it is important to control lupus activity.

Figures and Tables

Figure 1
Motor nerve conduction velocities. (A) Conduction block in both median, ulnar, tibial and peroneal nerves. (B) Absent F-wave in both median, ulnar, tibial and peroneal nerves.
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Figure 2
Right hand and left foot. Gangrenous change of right hand and left foot.
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Figure 3
Peripheral angiography of left leg. Anterior and posterior tibial arteries are occluded. Multiple collateral branches from peroneal artery supplies distal leg and foot.
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