Systemic lupus erythematosus presenting as Guillain‒Barre syndrome

A 37-year-old male patient presented with acute symmetrical ascending areflexic flaccid quadriparesis progressive in nature for the past 6 days before admission preceded by tingling sensation in both hands and feet with the right-sided lower motor type of facial nerve palsy for 2 days. Clinically, t...

Full description

Saved in:
Bibliographic Details
Main Authors: Arundhati Das, Niladri Sarkar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Annals of Medical Science and Research
Subjects:
Online Access:https://journals.lww.com/10.4103/amsr.amsr_11_22
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849236525898792960
author Arundhati Das
Niladri Sarkar
author_facet Arundhati Das
Niladri Sarkar
author_sort Arundhati Das
collection DOAJ
description A 37-year-old male patient presented with acute symmetrical ascending areflexic flaccid quadriparesis progressive in nature for the past 6 days before admission preceded by tingling sensation in both hands and feet with the right-sided lower motor type of facial nerve palsy for 2 days. Clinically, this was consistent with Guillain‒Barre (GB) syndrome and was given intravenous immunoglobulin (IVIG). Cerebrospinal fluid study and nerve conduction study also supported the clinical diagnosis of GB syndrome. He developed Type 2 respiratory failure on the 4th day of admission for which he was intubated. After successful extubation, his weakness even worsened markedly despite IVIG therapy and was subjected to plasmapheresis following which the weakness improved remarkably. On further investigation for the associated fever, arthralgia, pallor, nephritis, antinuclear antibody (3+ coarse speckled pattern), anti-smith antibody, and anti-dsDNA antibody positivity were detected with low serum complement levels, and renal biopsy revealing class III lupus nephritis. He was put on oral corticosteroids and cyclophosphamide which resulted in further clinical improvement. The initial presentation of GB syndrome of systemic lupus erythematosus is uncommon and makes this case interesting.
format Article
id doaj-art-82693186328f43528b7482a05eb5fada
institution Kabale University
issn 2949-785X
language English
publishDate 2022-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Annals of Medical Science and Research
spelling doaj-art-82693186328f43528b7482a05eb5fada2025-08-20T04:02:13ZengWolters Kluwer Medknow PublicationsAnnals of Medical Science and Research2949-785X2022-01-0111384010.4103/amsr.amsr_11_22Systemic lupus erythematosus presenting as Guillain‒Barre syndromeArundhati DasNiladri SarkarA 37-year-old male patient presented with acute symmetrical ascending areflexic flaccid quadriparesis progressive in nature for the past 6 days before admission preceded by tingling sensation in both hands and feet with the right-sided lower motor type of facial nerve palsy for 2 days. Clinically, this was consistent with Guillain‒Barre (GB) syndrome and was given intravenous immunoglobulin (IVIG). Cerebrospinal fluid study and nerve conduction study also supported the clinical diagnosis of GB syndrome. He developed Type 2 respiratory failure on the 4th day of admission for which he was intubated. After successful extubation, his weakness even worsened markedly despite IVIG therapy and was subjected to plasmapheresis following which the weakness improved remarkably. On further investigation for the associated fever, arthralgia, pallor, nephritis, antinuclear antibody (3+ coarse speckled pattern), anti-smith antibody, and anti-dsDNA antibody positivity were detected with low serum complement levels, and renal biopsy revealing class III lupus nephritis. He was put on oral corticosteroids and cyclophosphamide which resulted in further clinical improvement. The initial presentation of GB syndrome of systemic lupus erythematosus is uncommon and makes this case interesting.https://journals.lww.com/10.4103/amsr.amsr_11_22guillain‒barre syndromelupusneuropsychiatric systemic lupus erythematosus
spellingShingle Arundhati Das
Niladri Sarkar
Systemic lupus erythematosus presenting as Guillain‒Barre syndrome
Annals of Medical Science and Research
guillain‒barre syndrome
lupus
neuropsychiatric systemic lupus erythematosus
title Systemic lupus erythematosus presenting as Guillain‒Barre syndrome
title_full Systemic lupus erythematosus presenting as Guillain‒Barre syndrome
title_fullStr Systemic lupus erythematosus presenting as Guillain‒Barre syndrome
title_full_unstemmed Systemic lupus erythematosus presenting as Guillain‒Barre syndrome
title_short Systemic lupus erythematosus presenting as Guillain‒Barre syndrome
title_sort systemic lupus erythematosus presenting as guillain barre syndrome
topic guillain‒barre syndrome
lupus
neuropsychiatric systemic lupus erythematosus
url https://journals.lww.com/10.4103/amsr.amsr_11_22
work_keys_str_mv AT arundhatidas systemiclupuserythematosuspresentingasguillainbarresyndrome
AT niladrisarkar systemiclupuserythematosuspresentingasguillainbarresyndrome