A Case of Autoimmune Facial Swelling, Weakness, and Sensorineuropathy with Lower Limb Myositis
May 2022
in “
Journal of Neurology Neurosurgery & Psychiatry
”
TLDR The woman's facial symptoms are best explained by primary Sjögren’s Syndrome.
A 45-year-old woman with a 14-year history of myalgia, polyarthralgia, recurrent chest infections, oral ulcers, and hair loss was initially misdiagnosed with GCA/PMR but later identified as having SLE after developing new neurological symptoms. Despite normal initial imaging, further tests revealed bilateral sensory trigeminal neuropathy, asymmetric bifacial weakness, and myositis in the lower limbs. Immunology showed raised ESR, positive ANA, anti-Ro, and anti-La antibodies. The case highlights the overlap of symptoms between Sjögren’s Syndrome (SS) and Systemic Lupus Erythematosus (SLE), with major salivary gland enlargement and myositis being more common in primary SS but also present in this SLE case.