Systemic lupus erythematosus and critical illness polyneuropathy

Abstract

Systemic lupus erythematosus (SLE) is a chronic disease of connective tissue with multi-organ involvement. Manifestation in the nervous system is one of the most difficult symptoms to assess and interpret. The aim of the study is to indicate diagnostic problems in patients with SLE in whom neurological symptoms are present at the time of diagnosis of SLE but also with complications that occurred after diagnosis. In the presented case, the appearance of flaccid tetraparesis with areflexia suggested peripheral damage to the nervous system. In the electromyography performed in this patient, acute axonal polyneuropathy was mainly suspected. Further differential diagnosis should consider other acute and subacute developing polyneuropathies. Guillain-Barré polyneuropathy deserves special attention. To our knowledge, this is the first case documented in the literature of the coexistence of critical illness polyneuropathy and SLE.

Stroke and Multiorgan Failure as the Initial Manifestations of Lupus

“…Assessing nervous system involvement in SLE is challenging. Reported neurological complications range from 14% to 95% in SLE cases, which can be attributed to variations in the criteria used to define SLE [11,12]. Cerebrovascular disease may be directly attributed to the disease per se, a manifestation of neuropsychiatric SLE, or the result of traditional cardiovascular risk factors [11].…”

Acute psychosis as the presenting manifestation of lupus: case reports

“…Despite advances in the management of SLE, NPSLEs still pose a challenge; the diagnosis and attribution of SLE are difficult due to the lack of specific biomarkers or imaging, therapeutic options are limited, and evidence is mainly based on case reports, as clinical trials are sparse [2] . The diagnostic dilemma exists in SLE patients in whom neurological symptoms are present at diagnosis of SLE or as a later-on complication [10] .…”