Sensorimotor polyneuropathy: A rare manifestation in juvenile systemic lupus erythematosus

Nguyen Thi Van, Ha Thi Lieu, Nguyen Thanh Nam, Mai Thanh Cong

Main Article Content

Abstract

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that can affect nearly all organ systems thus presenting with diverse clinical manifestations. Among peripheral nervous system manifestations associated with pediatric SLE, polyneuropathy is uncommon, making diagnosis challenging, especially when it is the initial presentation of the disease. We report a case of a 15-years-old female patient with progressive quadriparesis accompanied by cutaneous and mucosal lesions lasting for three months. The patient was definitively diagnosed with sensorimotor polyneuropathy in the context of systemic lupus erythematosus and showed a favorable initial response to high-dose intravenous methylprednisolone therapy.

Article Details

References

1. Vina ER, Fang AJ, Wallace DJ, et al. Chronic inflammatory demyelinating polyneuropathy in patients with systemic lupus erythematosus: prognosis and outcome. Semin Arthritis Rheum. 2005;35(3):175-184. doi:10.1016/j.semarthrit.2005.08.008
2. Florica B, Aghdassi E, Su J, et al. Peripheral neuropathy in patients with systemic lupus erythematosus. Semin Arthritis Rheum. 2011;41(2):203-211. doi:10.1016/j.semarthrit.2011.04.001
3. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum. 1999;42(4):599-608. doi:10.1002/1529-0131(199904)42:4<599::AID-ANR2>3.0.CO;2-F
4. Giani T, Smith EM, Al-Abadi E, et al. Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study. Lupus. 2021;30(12):1955-1965. doi:10.1177/09612033211045050
5. Almeida RT, Campos LM de A, Aikawa NE, et al. Peripheral polineuropathy in patients with juvenile systemic lupus erythematosus. Rev Bras Reumatol. 2009;49:362-374. doi:https://doi.org/10.1590/S0482-50042009000400004
6. Toledano P, Orueta R, Rodríguez-Pintó I,et al. Peripheral nervous system involvement in systemic lupus erythematosus: Prevalence, clinical and immunological characteristics, treatment and outcome of a large cohort from a single centre. Autoimmun Rev. 2017;16(7):750-755. doi:10.1016/j.autrev.2017.05.011
7. Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019;71(9):1400-1412. doi:10.1002/art.40930
8. Shamim R, Farman S, Batool S, et al. Association of systemic lupus erythematosus disease activity index score with clinical and laboratory parameters in pediatric onset systemic lupus erythematosus. Pak J Med Sci. 2020;36(3):467-472. doi:10.12669/pjms. 36.3.1480
9. Steinlin MI, Blaser SI, Gilday DL, et al. Neurologic manifestations of pediatric systemic lupus erythematosus. Pediatr Neurol. 1995;13(3):191-197. doi:10.1016/0887-8994(9 5) 00110-2
10. Harel L, Mukamel M, Brik R, et al. Peripheral neuropathy in pediatric systemic lupus erythematosus. Pediatr Neurol. 2002;27(1):53-56. doi:10.1016/s0887-8994(02) 00377-6
11. van Doorn PA, Van den Bergh PYK, Hadden RDM, et al. European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain-Barré syndrome. Eur J Neurol. 2023;30(12):3646-3674. doi:10.1111/ene.16073
12. Van den Bergh PYK, van Doorn PA, Hadden RDM, et al. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force-Second revision. J Peripher Nerv Syst. 2021;26(3):242-268. doi:10.1111/jns.12455
13. Sommer C, Geber C, Young P, et al. Polyneuropathies. Dtsch Arztebl Int. 2018;115(6):83-90. doi:10.3238/arztebl.2018. 083
14. Brooks JA, McCudden C, Breiner A, et al. Causes of albuminocytological dissociation and the impact of age-adjusted cerebrospinal fluid protein reference intervals: a retrospective chart review of 2627 samples collected at tertiary care centre. BMJ Open. 2019;9(2):e025348. doi:10.1136/bmjopen-2018-025348
15. Bortoluzzi A, Piga M, Silvagni E, et al. Peripheral nervous system involvement in systemic lupus erythematosus: a retrospective study on prevalence, associated factors and outcome. Lupus. 2019;28(4):465-474. doi:10.1177/0961203319828499