Systemic lupus erythematous with recurrent Guillain -Barré-like syndrome treated with intravenous immunoglobulins

Abstract

We report on an unusual case of a young African male with systemic lupus erythematosus who developed an acute, severe Guillain-Barré-like peripheral neuropathy associated with ascites. The illness appeared to respond dramatically to a short course of intravenous immunoglobulins. Eight months later he had recurrence of identical features. He required respiratory support. On this occasion there was no response to intravenous immunoglobulins or other measures and he died of sepsis after a protracted period of paralysis.

Fulminant Guillain-Barré syndrome in a patient with systemic lupus erythematosus

“…Review of the literature reveals that cases of GBS in the context of SLE have predominantly presented with acute inflammatory demyelinating polyneuropathy followed by the acute motor axonal neuropathy variant 6–19. Rare cases of acute motor sensory axonal neuropathy,14 20 Miller-Fisher syndrome21 and pharyngeal-cervical-brachial syndrome22 have also been reported.…”

Gastrointestinal and neurological manifestations in systemic lupus erythematosu

“…Regarding the mechanism of headache, none was identified and no correlation between headache and the disease status has been established.  Peripheral neuropathy is also a common manifestation in SLE, seen in 15% of patients 40 . Most of the times it is asymmetric, sensory nerves are affected more than motor nerves and more than one nerve may be damaged 40 .…”

“… Peripheral neuropathy is also a common manifestation in SLE, seen in 15% of patients 40 . Most of the times it is asymmetric, sensory nerves are affected more than motor nerves and more than one nerve may be damaged 40 . In a few case reports, patients presented with inflammatory polyradiculoneuropathy, including the acute form resembling Guillain-Barré syndrome and the chronic form resembling chronic inflammatory demyelinating polyradiculoneuropathy (CIPD) 40,41 .…”

High-Dose Intravenous Immunoglobulins: An Option in the Treatment of Systemic Lupus Erythematosus

“…Winder et al [40] reported on the successful outcome in a patient with lupus pneumonitis and encephalitis who received continuous treatment with IVIG, every 4 weeks for up to 20 months, which induced a prolonged clinical and laboratory remission. Lewis and Gibson [41] reported on a man with SLE who developed an acute, severe Guillain-Barré-like peripheral neuropathy associated with ascites. The first episode of the illness responded dramatically to a short course of IVIG.…”