Multiple neurological manifestations in a patient with systemic lupus erythematosus and anti-NXP2-positive myositis: A case report.

Abstract

RATIONALE:

Systemic lupus erythematosus (SLE) is a complex autoimmune inflammatory disease that frequently affects various organs. Neuropsychiatric manifestations in SLE patients, known as neuropsychiatric SLE, are clinically common. However, the principal manifestation of cranial neuropathy in patients with SLE and comorbidities is relatively rare.

PATIENT CONCERNS:

In this report, we describe a 51-year-old Chinese woman who was admitted with a chief complaint of chronic-onset facial paresthesia, dysphagia, and choking cough when drinking water, accompanied by slurred speech, salivation, and limb weakness. The blood autoantibody test results showed that many SLE-associated antibodies were positive. Meanwhile, anti-nuclear matrix protein 2 (NXP2) antibody was strongly positive in the idiopathic inflammatory myopathy (IIM) spectrum test from the serum. Muscle biopsy indicated inflammatory infiltration of the muscle fiber stroma.

DIAGNOSES:

Taking into account the clinical manifestations and laboratory tests of the present case, the diagnosis of SLE and probable IIM was established.

INTERVENTIONS:

Corticosteroids and additional gamma globulin were administered and the clinical symptoms were relieved during the treatment process.

OUTCOMES:

Unfortunately, the patient experienced sudden cardiac and respiratory arrest. Multiple system dysfunctions exacerbated disease progression, but in the present case, we speculated that myocardial damage resulting from SLE could explain why she suddenly died.

LESSONS:

To our knowledge, multiple neurological manifestations in patients with SLE and anti-NXP2-positive myositis are rare. Note that SLE is still a life-threatening disease that causes multiple system dysfunctions, which requires increasing attention.

• Authors: Xiaojie Cao, Mingjie Zhang, Zhijie Lu, Congyang Li, Yanping Zeng, Jin Fan, Ke Yu
• Journal: Medicine (Medicine (Baltimore)) Vol. 100 Issue 10 Pg. e25063 (Mar 12 2021) ISSN: 1536-5964 [Electronic] United States
• PMID: 33725895 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Chemical References

• Autoantibodies
• DNA-Binding Proteins
• Immunologic Factors
• Adenosine Triphosphatases
• MORC3 protein, human

Topics

• Adenosine Triphosphatases (immunology)
• Autoantibodies (blood, immunology)
• Biopsy
• Cranial Nerve Diseases (diagnosis, drug therapy, immunology)
• DNA-Binding Proteins (immunology)
• Deglutition Disorders (diagnosis, drug therapy, immunology)
• Drug Therapy, Combination (methods)
• Fatal Outcome
• Female
• Humans
• Immunologic Factors (administration & dosage)
• Lupus Erythematosus, Systemic (complications, diagnosis, drug therapy, immunology)
• Middle Aged
• Muscle, Skeletal (immunology, pathology)
• Paresthesia (diagnosis, drug therapy, immunology)
• Polymyositis (complications, diagnosis, drug therapy, immunology)
• Pulse Therapy, Drug