Severe Lupus Vasculitic Neuropathy

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.