A Case of Autoimmune Facial Swelling, Weakness, and Sensorineuropathy with Lower Limb Myositis

This case study describes a 45-year-old woman with a 14-year history of symptoms including myalgia, polyarthralgia, recurrent chest infections, oral ulcers, hair loss, and recent jaw and facial pain. Initially misdiagnosed with GCA/PMR, she was later diagnosed with SLE after developing additional symptoms such as slurred speech, facial weakness, and vomiting. Neurological examination revealed bilateral sensory trigeminal neuropathy and asymmetric bifacial weakness. Immunological tests showed raised ESR, positive ANA, anti-Ro, and anti-La antibodies. Imaging and biopsy results indicated myositis and mild lymphocytic infiltration. The study concludes that major salivary gland enlargement, common in primary Sjögren’s Syndrome (SS), best explains the facial symptoms, while myositis overlaps between SS and SLE but is more common in primary SS.