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DOI: 10.48087/BJMS.2026.130412
Authors: Ayoub REMILAOUI¹, Hadjer CHIBA¹˒², Farida MECHID-HADJARAB¹˒², Chafia DAHOU-MAKHLOUFI¹˒²
Affiliations: 1- Department of Rheumatology, Bab El Oued University Hospital Center, Algiers, Algeria. 2- Faculty of Medicine, Youcef El Khatib University of Health Sciences, Algiers, Algeria.
Abstract
Background: Peripheral neuropathy is an uncommon but potentially disabling manifestation of systemic lupus erythematosus (SLE), particularly when it occurs early in the disease course. Its clinical and electrophysiological heterogeneity often makes diagnosis challenging. Case Presentation: We report the case of a 21-year-old man presenting with inflammatory arthralgia followed by progressive sensorimotor peripheral neuropathy predominantly affecting the lower limbs. Electroneuromyography revealed a diffuse sensorimotor polyneuropathy with severe axonal involvement and demyelinating features. Immunological investigations showed high-titer antinuclear antibodies, positive anti-double-stranded DNA and anti-nucleosome antibodies, and normal complement levels. A structured diagnostic work-up excluded alternative metabolic, infectious, toxic, and drug-related etiologies. The diagnosis of active SLE was established according to the 2019 ACR/EULAR classification criteria. Treatment with high-dose corticosteroids, hydroxychloroquine, and immunosuppressive therapy resulted in progressive clinical and electrophysiological improvement. Conclusion: This case highlights that peripheral sensorimotor neuropathy may represent an early manifestation of SLE. Early recognition and individualized immunosuppressive management are essential to improve neurological outcomes and limit long-term disability.
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Keywords: systemic lupus erythematosus, peripheral neuropathy, neuropsychiatric lupus, sensorimotor neuropathy, immunosuppressive therapy.