Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disease, of the connectivitis group. This condition particularly affects young women between the ages of 20 and 40. Several systems are affected during the disease including the nervous system where central damage is more described than peripheral damage. We report here the case of a 15 year old male teenager with systemic lupus erythematosus whose initial clinical manifestation was acute inflammatory axonal polyneuropathy. This diagnosis was made on the basis of allodynia predominantly in gloves and socks with clinical examination of bilateral peripheral neurogenic syndrome predominant in both lower limbs all associated with fever. The electroneuromyogram showed signs of sensory and motor impairment (more marked in sensory) of the axonal type in both lower limbs, compatible with polyneuropathy. The patient developed several skin lesions such as erythematous and scaly patches on the extremities, and purpuric macules of the palms of hands. All the antibodies tested in the blood came back positive and the skin biopsy described a proliferation of vascular capillaries with a fibrous and myxoid wall, dissociated by inflammatory cells, suggesting inflammatory involvement. Under treatment with hydroxychloroquine and corticosteroids, the patient presented a marked improvement in the general condition as well as on the functional level with regression of sensory and motor disorders.