Severe Lupus Vasculitic Neuropathy

A 31-year-old woman with severe axonal sensorimotor neuropathy, joint symptoms, rash, and hair loss was diagnosed with severe multisystem lupus vasculitis after testing positive for lupus and antiphospholipid antibodies. Initially suspected of having Guillain–Barré syndrome, she received intravenous immunoglobulin (IVIG) before the correct diagnosis was made. Treatment with cyclophosphamide and prednisolone led to significant improvement. The case highlights the challenges in diagnosing and treating neurological lupus, particularly the under-recognized presentation of peripheral neuropathy and the complexities of interpreting autoantibody serology post-IVIG treatment.