Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”

Paul-Cedric Mbonda; Grâce Nkoro; Daniel Massi Gams; Yannick Fogang; Callixte Kuate

doi:doi:10.11648/j.cnn.20210504.12

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Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”

Paul-Cedric Mbonda, Grâce Nkoro, Daniel Massi Gams, Yannick Fogang, Callixte Kuate

Published in Clinical Neurology and Neuroscience (Volume 5, Issue 4)

Received: 17 July 2021 Accepted: 16 August 2021 Published: 19 October 2021

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Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disease, of the connectivitis group. This condition particularly affects young women between the ages of 20 and 40. Several systems are affected during the disease including the nervous system where central damage is more described than peripheral damage. We report here the case of a 15 year old male teenager with systemic lupus erythematosus whose initial clinical manifestation was acute inflammatory axonal polyneuropathy. This diagnosis was made on the basis of allodynia predominantly in gloves and socks with clinical examination of bilateral peripheral neurogenic syndrome predominant in both lower limbs all associated with fever. The electroneuromyogram showed signs of sensory and motor impairment (more marked in sensory) of the axonal type in both lower limbs, compatible with polyneuropathy. The patient developed several skin lesions such as erythematous and scaly patches on the extremities, and purpuric macules of the palms of hands. All the antibodies tested in the blood came back positive and the skin biopsy described a proliferation of vascular capillaries with a fibrous and myxoid wall, dissociated by inflammatory cells, suggesting inflammatory involvement. Under treatment with hydroxychloroquine and corticosteroids, the patient presented a marked improvement in the general condition as well as on the functional level with regression of sensory and motor disorders.

Published in	Clinical Neurology and Neuroscience (Volume 5, Issue 4)
DOI	10.11648/j.cnn.20210504.12
Page(s)	78-81
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Polyneuropathy, Lupus, Teenager, Case Report

References

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[2]	Alessandra Bortoluzzi, Ettore Silvagni, Federica Furini, Matteo Piga, Marcello Govoni. Peripheral nervous system involvement in systemic lupus erythematosus: a review of the evidence. Clin Exp Rheumatol. 2019; 37 (1): 146-155.
[3]	Jonathan Y Streifler, Yair Molad. Connective tissue disorders: systemic lupus erythematosus, Sjögren's syndrome, and scleroderma. Handb Clin Neurol. 2014; 119: 463-73.
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[5]	McGlasson S, Wiseman S, Wardlaw J, Dhaun N, Hunt DPJ. Neurological Disease in Lupus: Toward a Personalized Medicine Approach. Front Immunol. 2018 Jun 6; 9: 1146.
[6]	Cavallasca JA, Cousillas JE. Numbness and Weakness in a Patient with Systemic Lupus Erythematosus. Am J Med. 2021 Jan; 134 (1): e53-e54.
[7]	Xiangling Li, Yanqiang Wang. Systemic Lupus Erythematosus with Acute Inflammatory Demyelinating Polyneuropathy: A Case Report and Review of the Literature. Case Reports. J Clin Med Res. 2016 Jul; 8 (7): 555-9.
[8]	R Jasmin, S Sockalingam, L P Ramanaidu, K J Goh. Clinical and electrophysiological characteristics of symmetric polyneuropathy in a cohort of systemic lupus erythematosus patients. Lupus. 2015; 24 (3): 248-55.
[9]	Wang Xianbin, Wang Mingyu, Xu Dong, Li Huiying, Xu Yan, Zhang Fengchun, Zeng Xiaofeng. Peripheral neuropathies due to systemic lupus erythematosus in China. Medicine (Baltimore). 2015; 94 (11): e625.
[10]	Brandusa Florica, Ellie Aghdassi, Jiandong Su, Dafna D Gladman, Murray B Urowitz, Paul R Fortin. Peripheral neuropathy in patients with systemic lupus erythematosus. Semin Arthritis Rheum. 2011; 41 (2): 203-11.
[11]	Pilar Toledano, Ramón Orueta, Ignasi Rodríguez-Pintó, Josep Valls-Solé, Ricard Cervera, Gerard Espinosa. Peripheral nervous system involvement in systemic lupus erythematosus: Prevalence, clinical and immunological characteristics, treatment and outcome of a large cohort from a single centre. Autoimmun Rev 2017; 16 (7): 750-55.
[12]	J. D. England, G. S. Gronseth, G. Franklin, G. T. Carter, L. J. Kinsella, J. A. Cohen, A. K. Asbury, K. Szigeti, J. R. Lupski, N. Latov, R. A. Lewis, P. A. Low, M. A. Fisher, D. N. Herrmann, J. F. Howard, G. Lauria, R. G. Miller, M. Polydefkis, A. J. Sumner. Practice Parameter: Evaluation of distal symmetric polyneuropathy: Role of laboratory and genetic testing (an evidence-based review). Neurology. 2009; 1 (1): 5-13.
[13]	Martin Aringer, Nicolai Leuchten, Sindhu R Johnson. New Criteria for Lupus. Curr Rheumatol Rep. 2020; 22 (6): 18.
[14]	J K Presto, E Z Hejazi, V P Werth. Biological therapies in the treatment of cutaneous lupus erythematosus. Lupus. 2017; 26 (2): 115-118.
[15]	Coomes EA, Haghbayan H, Spring J, Mehta S. Fulminant Guillain-Barre syndrome in a patient with systemic lupus erythematosus. BMJ Case Rep. 2019 Jan 14; 12 (1): bcr-2018-226634.
[16]	Sodavarapu S, Rudrangi R, Hoffman J. Rare case of bilateral wrist and foot drop from SLE-related vasculitic polyneuropathy. BMJ Case Rep. 2020 Jan 15; 13 (1): e232890.

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APA Style

Paul-Cedric Mbonda, Grâce Nkoro, Daniel Massi Gams, Yannick Fogang, Callixte Kuate. (2021). Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”. Clinical Neurology and Neuroscience, 5(4), 78-81. https://doi.org/10.11648/j.cnn.20210504.12

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ACS Style

Paul-Cedric Mbonda; Grâce Nkoro; Daniel Massi Gams; Yannick Fogang; Callixte Kuate. Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”. Clin. Neurol. Neurosci. 2021, 5(4), 78-81. doi: 10.11648/j.cnn.20210504.12

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AMA Style

Paul-Cedric Mbonda, Grâce Nkoro, Daniel Massi Gams, Yannick Fogang, Callixte Kuate. Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”. Clin Neurol Neurosci. 2021;5(4):78-81. doi: 10.11648/j.cnn.20210504.12

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@article{10.11648/j.cnn.20210504.12,
  author = {Paul-Cedric Mbonda and Grâce Nkoro and Daniel Massi Gams and Yannick Fogang and Callixte Kuate},
  title = {Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”},
  journal = {Clinical Neurology and Neuroscience},
  volume = {5},
  number = {4},
  pages = {78-81},
  doi = {10.11648/j.cnn.20210504.12},
  url = {https://doi.org/10.11648/j.cnn.20210504.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20210504.12},
  abstract = {Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disease, of the connectivitis group. This condition particularly affects young women between the ages of 20 and 40. Several systems are affected during the disease including the nervous system where central damage is more described than peripheral damage. We report here the case of a 15 year old male teenager with systemic lupus erythematosus whose initial clinical manifestation was acute inflammatory axonal polyneuropathy. This diagnosis was made on the basis of allodynia predominantly in gloves and socks with clinical examination of bilateral peripheral neurogenic syndrome predominant in both lower limbs all associated with fever. The electroneuromyogram showed signs of sensory and motor impairment (more marked in sensory) of the axonal type in both lower limbs, compatible with polyneuropathy. The patient developed several skin lesions such as erythematous and scaly patches on the extremities, and purpuric macules of the palms of hands. All the antibodies tested in the blood came back positive and the skin biopsy described a proliferation of vascular capillaries with a fibrous and myxoid wall, dissociated by inflammatory cells, suggesting inflammatory involvement. Under treatment with hydroxychloroquine and corticosteroids, the patient presented a marked improvement in the general condition as well as on the functional level with regression of sensory and motor disorders.},
 year = {2021}
}

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TY  - JOUR
T1  - Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”
AU  - Paul-Cedric Mbonda
AU  - Grâce Nkoro
AU  - Daniel Massi Gams
AU  - Yannick Fogang
AU  - Callixte Kuate
Y1  - 2021/10/19
PY  - 2021
N1  - https://doi.org/10.11648/j.cnn.20210504.12
DO  - 10.11648/j.cnn.20210504.12
T2  - Clinical Neurology and Neuroscience
JF  - Clinical Neurology and Neuroscience
JO  - Clinical Neurology and Neuroscience
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EP  - 81
PB  - Science Publishing Group
SN  - 2578-8930
UR  - https://doi.org/10.11648/j.cnn.20210504.12
AB  - Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disease, of the connectivitis group. This condition particularly affects young women between the ages of 20 and 40. Several systems are affected during the disease including the nervous system where central damage is more described than peripheral damage. We report here the case of a 15 year old male teenager with systemic lupus erythematosus whose initial clinical manifestation was acute inflammatory axonal polyneuropathy. This diagnosis was made on the basis of allodynia predominantly in gloves and socks with clinical examination of bilateral peripheral neurogenic syndrome predominant in both lower limbs all associated with fever. The electroneuromyogram showed signs of sensory and motor impairment (more marked in sensory) of the axonal type in both lower limbs, compatible with polyneuropathy. The patient developed several skin lesions such as erythematous and scaly patches on the extremities, and purpuric macules of the palms of hands. All the antibodies tested in the blood came back positive and the skin biopsy described a proliferation of vascular capillaries with a fibrous and myxoid wall, dissociated by inflammatory cells, suggesting inflammatory involvement. Under treatment with hydroxychloroquine and corticosteroids, the patient presented a marked improvement in the general condition as well as on the functional level with regression of sensory and motor disorders.
VL  - 5
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ER  -

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Author Information

Paul-Cedric Mbonda

Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
Grâce Nkoro
Daniel Massi Gams

Faculty of Medicine and Pharmaceutical Sciences, University of Buea, Buea, Cameroon
Yannick Fogang

Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
Callixte Kuate

Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

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APA Style

Paul-Cedric Mbonda, Grâce Nkoro, Daniel Massi Gams, Yannick Fogang, Callixte Kuate. (2021). Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”. Clinical Neurology and Neuroscience, 5(4), 78-81. https://doi.org/10.11648/j.cnn.20210504.12

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ACS Style

Paul-Cedric Mbonda; Grâce Nkoro; Daniel Massi Gams; Yannick Fogang; Callixte Kuate. Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”. Clin. Neurol. Neurosci. 2021, 5(4), 78-81. doi: 10.11648/j.cnn.20210504.12

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AMA Style

Paul-Cedric Mbonda, Grâce Nkoro, Daniel Massi Gams, Yannick Fogang, Callixte Kuate. Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”. Clin Neurol Neurosci. 2021;5(4):78-81. doi: 10.11648/j.cnn.20210504.12

Copy | Download

@article{10.11648/j.cnn.20210504.12,
  author = {Paul-Cedric Mbonda and Grâce Nkoro and Daniel Massi Gams and Yannick Fogang and Callixte Kuate},
  title = {Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”},
  journal = {Clinical Neurology and Neuroscience},
  volume = {5},
  number = {4},
  pages = {78-81},
  doi = {10.11648/j.cnn.20210504.12},
  url = {https://doi.org/10.11648/j.cnn.20210504.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20210504.12},
  abstract = {Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disease, of the connectivitis group. This condition particularly affects young women between the ages of 20 and 40. Several systems are affected during the disease including the nervous system where central damage is more described than peripheral damage. We report here the case of a 15 year old male teenager with systemic lupus erythematosus whose initial clinical manifestation was acute inflammatory axonal polyneuropathy. This diagnosis was made on the basis of allodynia predominantly in gloves and socks with clinical examination of bilateral peripheral neurogenic syndrome predominant in both lower limbs all associated with fever. The electroneuromyogram showed signs of sensory and motor impairment (more marked in sensory) of the axonal type in both lower limbs, compatible with polyneuropathy. The patient developed several skin lesions such as erythematous and scaly patches on the extremities, and purpuric macules of the palms of hands. All the antibodies tested in the blood came back positive and the skin biopsy described a proliferation of vascular capillaries with a fibrous and myxoid wall, dissociated by inflammatory cells, suggesting inflammatory involvement. Under treatment with hydroxychloroquine and corticosteroids, the patient presented a marked improvement in the general condition as well as on the functional level with regression of sensory and motor disorders.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Axonal Polyneuropathy as Initial Presentation of Lupus in a 15-year-old Male Teenager “Case Report”
AU  - Paul-Cedric Mbonda
AU  - Grâce Nkoro
AU  - Daniel Massi Gams
AU  - Yannick Fogang
AU  - Callixte Kuate
Y1  - 2021/10/19
PY  - 2021
N1  - https://doi.org/10.11648/j.cnn.20210504.12
DO  - 10.11648/j.cnn.20210504.12
T2  - Clinical Neurology and Neuroscience
JF  - Clinical Neurology and Neuroscience
JO  - Clinical Neurology and Neuroscience
SP  - 78
EP  - 81
PB  - Science Publishing Group
SN  - 2578-8930
UR  - https://doi.org/10.11648/j.cnn.20210504.12
AB  - Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disease, of the connectivitis group. This condition particularly affects young women between the ages of 20 and 40. Several systems are affected during the disease including the nervous system where central damage is more described than peripheral damage. We report here the case of a 15 year old male teenager with systemic lupus erythematosus whose initial clinical manifestation was acute inflammatory axonal polyneuropathy. This diagnosis was made on the basis of allodynia predominantly in gloves and socks with clinical examination of bilateral peripheral neurogenic syndrome predominant in both lower limbs all associated with fever. The electroneuromyogram showed signs of sensory and motor impairment (more marked in sensory) of the axonal type in both lower limbs, compatible with polyneuropathy. The patient developed several skin lesions such as erythematous and scaly patches on the extremities, and purpuric macules of the palms of hands. All the antibodies tested in the blood came back positive and the skin biopsy described a proliferation of vascular capillaries with a fibrous and myxoid wall, dissociated by inflammatory cells, suggesting inflammatory involvement. Under treatment with hydroxychloroquine and corticosteroids, the patient presented a marked improvement in the general condition as well as on the functional level with regression of sensory and motor disorders.
VL  - 5
IS  - 4
ER  -

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