• Military medicine · Feb 2024

    Case Reports

    Systemic Lupus Erythematosus Initially Presenting as Acute Motor and Sensory Axonal Neuropathy Variant of Guillain-Barre Syndrome in a Healthy Active Duty Female.

    • Samantha Braun, Luisa Bastian, Corey Hayes, Samuel Craig Owen, Cassandra Craig, and Alexis Nelson.
    • The Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA.
    • Mil Med. 2024 Feb 27; 189 (3-4): e915e918e915-e918.

    AbstractGuillain-Barre syndrome (GBS) is an acute monophasic immune-mediated polyradiculoneuropathy characterized by rapidly evolving ascending weakness, mild sensory loss, and hypo- or areflexia, typically progressing to peak symptoms over the course of 4 weeks. The precise mechanism is unclear but is proposed to be an immune-mediated reaction with the generation of antibodies against peripheral nerves triggered by a preceding viral infection. Acute motor and sensory axonal neuropathy (AMSAN) is a rare and severe variant of Guillain-Barre syndrome with limited published literature. Discussion of risk factors for this subtype has not been done in a systematic way. This case report involves a 34-year-old, active duty, West African female, who immigrated to the United States in 2019. She presented with worsening diplopia, bilateral distal upper and lower extremity paresthesias as well as progressively worsening bilateral upper extremity weakness. Her clinical picture was complicated by constitutional symptoms, diffuse lymphadenopathy, no preceding viral illness, and marked clinical deterioration. Ultimately, she was diagnosed with acute motor and sensory axonal neuropathy in the setting of a new diagnosis of systemic lupus erythematosus, a rarely described association emphasizing the importance of a thorough evaluation for underlying causes of acute neurologic pathologies.© The Association of Military Surgeons of the United States 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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