Neurological manifestations in systemic lupus erythematosus: A case with an individualized therapeutic approach

Abstract

Vasculitis occurs frequently in systemic lupus erythematosus (SLE) patients with an active disease and poor prognosis. Nervous system vasculitis – specifically, multiple mononeuropathy, seizures, and transverse myelitis – is among the most severe complications in SLE that need timely aggressive therapy. Unfortunately, no robust literature is available to guide their management, and therapeutic recommendations are commonly based upon other autoimmune conditions or case reports, case series, and expert opinions. We hereby present a case of a 27-year-old female patient with SLE that sequentially developed an asymmetric distal axonal sensorimotor neuropathy in her limbs and digital ischemic lesions of the hands, that progressed despite maximal treatment with standard therapies, thus requiring several sessions of plasmapheresis.