Limits...
A Case of Systemic Lupus Erythematosus Presenting as Guillain-Barré Syndrome.

Okoh HC, Lubana SS, Langevin S, Sanelli-Russo S, Abrudescu A - Case Rep Rheumatol (2015)

Bottom Line: Systemic lupus erythematosus (SLE) is an autoimmune systemic disease with multiple organ involvement with high morbidity and mortality rate.Among the severe potential fatal complications are those of the central and peripheral nervous system which usually develop during the course of the disease and very rarely from the outset of the disease.We are reporting a rare case of Miller-Fisher (MFS) variant of Guillain-Barré syndrome (GBS) as the first manifestation of SLE in a 41-year-old female who progressed to flaccid paralysis with no neurological improvement with initial immunosuppressive therapy, plasmapheresis, and first cycle of intravenous immunoglobulin (IVIG) but with remarkable and complete recovery after the second 5-day course of IVIG.

View Article: PubMed Central - PubMed

Affiliation: Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, NY 11432, USA.

ABSTRACT
Systemic lupus erythematosus (SLE) is an autoimmune systemic disease with multiple organ involvement with high morbidity and mortality rate. Among the severe potential fatal complications are those of the central and peripheral nervous system which usually develop during the course of the disease and very rarely from the outset of the disease. We are reporting a rare case of Miller-Fisher (MFS) variant of Guillain-Barré syndrome (GBS) as the first manifestation of SLE in a 41-year-old female who progressed to flaccid paralysis with no neurological improvement with initial immunosuppressive therapy, plasmapheresis, and first cycle of intravenous immunoglobulin (IVIG) but with remarkable and complete recovery after the second 5-day course of IVIG.

No MeSH data available.


Related in: MedlinePlus

Kidney biopsy: membranous and focal lupus nephritis [ISN/PPS 2004 classification lupus nephritis, classes III (A) and V]; acute tubular necrosis.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4553270&req=5

fig3: Kidney biopsy: membranous and focal lupus nephritis [ISN/PPS 2004 classification lupus nephritis, classes III (A) and V]; acute tubular necrosis.

Mentions: Due to the presence of leukopenia, pericardial and pleural effusions, proteinuria, and hematuria SLE work-up was sent with results showing the following: +ANA titers of 1 : 2560 4+ speckled, Anti-ds-DNA positive titer 1 : 80, and AntiSmith ab positive >8, low C3 and C4 levels at <40 mg/dL and <10 mg/dL, respectively. Serum antiribosomal P antibodies positive >8, serum antineuronal antibodies were negative, and lupus anticoagulant and anticardiolipin antibodies were negative. Patient fulfilled ACR SLE criteria and Pulse SoluMedrol therapy 1 gm daily for 3 consecutive days was started 7 days after admission. Renal function was rapidly deteriorating with anuria at 67 mL in 24 hours and worsening of BUN/creatinine to 50/3.29 mg/dL, respectively; hemodialysis (HD) was started 8 days after admission. Renal biopsy was performed which showed evidence of membranous and focal lupus nephritis [ISN/RPS 2004 classification lupus nephritis, classes III (A) and V], acute tubular necrosis (Figure 3).


A Case of Systemic Lupus Erythematosus Presenting as Guillain-Barré Syndrome.

Okoh HC, Lubana SS, Langevin S, Sanelli-Russo S, Abrudescu A - Case Rep Rheumatol (2015)

Kidney biopsy: membranous and focal lupus nephritis [ISN/PPS 2004 classification lupus nephritis, classes III (A) and V]; acute tubular necrosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4553270&req=5

fig3: Kidney biopsy: membranous and focal lupus nephritis [ISN/PPS 2004 classification lupus nephritis, classes III (A) and V]; acute tubular necrosis.
Mentions: Due to the presence of leukopenia, pericardial and pleural effusions, proteinuria, and hematuria SLE work-up was sent with results showing the following: +ANA titers of 1 : 2560 4+ speckled, Anti-ds-DNA positive titer 1 : 80, and AntiSmith ab positive >8, low C3 and C4 levels at <40 mg/dL and <10 mg/dL, respectively. Serum antiribosomal P antibodies positive >8, serum antineuronal antibodies were negative, and lupus anticoagulant and anticardiolipin antibodies were negative. Patient fulfilled ACR SLE criteria and Pulse SoluMedrol therapy 1 gm daily for 3 consecutive days was started 7 days after admission. Renal function was rapidly deteriorating with anuria at 67 mL in 24 hours and worsening of BUN/creatinine to 50/3.29 mg/dL, respectively; hemodialysis (HD) was started 8 days after admission. Renal biopsy was performed which showed evidence of membranous and focal lupus nephritis [ISN/RPS 2004 classification lupus nephritis, classes III (A) and V], acute tubular necrosis (Figure 3).

Bottom Line: Systemic lupus erythematosus (SLE) is an autoimmune systemic disease with multiple organ involvement with high morbidity and mortality rate.Among the severe potential fatal complications are those of the central and peripheral nervous system which usually develop during the course of the disease and very rarely from the outset of the disease.We are reporting a rare case of Miller-Fisher (MFS) variant of Guillain-Barré syndrome (GBS) as the first manifestation of SLE in a 41-year-old female who progressed to flaccid paralysis with no neurological improvement with initial immunosuppressive therapy, plasmapheresis, and first cycle of intravenous immunoglobulin (IVIG) but with remarkable and complete recovery after the second 5-day course of IVIG.

View Article: PubMed Central - PubMed

Affiliation: Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, NY 11432, USA.

ABSTRACT
Systemic lupus erythematosus (SLE) is an autoimmune systemic disease with multiple organ involvement with high morbidity and mortality rate. Among the severe potential fatal complications are those of the central and peripheral nervous system which usually develop during the course of the disease and very rarely from the outset of the disease. We are reporting a rare case of Miller-Fisher (MFS) variant of Guillain-Barré syndrome (GBS) as the first manifestation of SLE in a 41-year-old female who progressed to flaccid paralysis with no neurological improvement with initial immunosuppressive therapy, plasmapheresis, and first cycle of intravenous immunoglobulin (IVIG) but with remarkable and complete recovery after the second 5-day course of IVIG.

No MeSH data available.


Related in: MedlinePlus