RESEARCH ARTICLE


Chronic Inflammatory Demyelinating Polyneuropathy in Systemic Lupus Erythematosus: A Rare Entity



Rozita Mohd*, Fatimah Zanirah Nordin, Rizna Cader
Nephrology Unit, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, 56000, Cheras Kuala Lumpur, Malaysia


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Creative Commons License
© 2018 Mohd et al

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Nephrology Unit, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, 56000, Cheras Kuala Lumpur, Malaysia; Tel: +60122022794; E-mail: rozi8286@gmail.com


Abstract

Background:

Neurological manifestations in Systemic Lupus Erythematous (SLE) varies and commonly affects the Central Nervous System (CNS) rather than the peripheral nervous system. Neuropsychiatric or CNS manifestation can be as high as 24-54%, whereas the peripheral nervous system involvement is lower around 5-27%. Chronic Inflammatory Demyelinating Polyradiculopathy (CIDP) is one of the three commonest peripheral nervous system involvements in SLE patients and results with severe debilitating effects. However, it is rarely reported.

Methods:

A retrospective review of all SLE patients that were diagnosed with CIDP between 2000 and 2015 was done under follow up at our center that were diagnosed with CIDP between 2000 and 2015. We reviewed their medical records and analyzed their clinical presentation, investigations, treatment instituted, response to therapy and any neurological sequealae.

Results:

A total of 512 case notes were reviewed. Of these 4 patients presented with CIDP (3 females, 1 male) aged between 26 to 46 years old. Three presented with transverse myelitis and the other one with acute motor and sensory axonal neuropathy. All patients were treated with high dose corticosteroids, three patients received cyclophosphamide whilst the other patient was induced with mycophenolate mofetil. Complete recovery was seen in one patient, two had persistent but improving numbness and the other one had a residual weakness.

Conclusion:

Peripheral nervous system involvement in SLE can result in serious debilitating effects. Early diagnosis and treatment are crucial in limiting the neurological sequealae.

Keywords: Chronic inflammatory demyelinating polyradiculopathy, cyclophosphamide, Neurological, Systemic lupus erythematous, Peripheral nervous system, Debilitating effects.