Severe Lupus Vasculitic Neuropathy

    November 2025 in “ Practical Neurology ”
    Apoorva Anil Kumar, Victor Jia Wei Zhang, Carine J Moezinia, Sarah Levy, Fernanda Ruiz, Sebastian Brandner, Frederick Schon, Hamid Modarres, Alexander M Rossor, Apoorva Anil Kumar, Victor Jia Wei Zhang, Carine J Moezinia, Sarah Levy, Fernanda Ruiz, Sebastian Brandner, Frederick Schon, Hamid Modarres, Alexander M Rossor
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    Studysummary In this case report, a 31-year-old woman with severe multisystem lupus vasculitis initially presented with generalized pain and rapidly worsening neuropathy, ultimately improving with cyclophosphamide and prednisolone treatment. The authors highlight diagnostic challenges, particularly in interpreting autoantibody results after IVIG therapy. Our plain-language summary of this paper — not a Tressless recommendation.
    The document discusses a case of a 31-year-old woman with severe lupus vasculitic neuropathy, presenting with generalized pain, weakness, transient joint symptoms, rash, and hair loss. Initially suspected of having Guillain–Barré syndrome, she was treated with intravenous immunoglobulin, but subsequent tests revealed strongly positive lupus and antiphospholipid antibody titres. She was diagnosed with severe multisystem lupus vasculitis affecting both the central and peripheral nervous systems and was treated with cyclophosphamide and prednisolone, leading to notable improvement. The case highlights the challenges in diagnosing and treating neurological lupus, particularly the under-recognition of peripheral neuropathy as a presenting symptom.
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