Peripheral neuropathy in systemic lupus — case report

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease developing as a result of complex disorders of the immune system. It leads to chronic inflammation including many tissues and organs. Changes in the kidneys (lupus nephritis) is currently developing in approximately 60–80% of patients (in Europe about 30–50%). Nephritis is oneof the most serious manifestations of systemic lupus erythematosus. This is due to the deposition of immune complexes in the kidney of all structures. Nephropathy may occur as chronic glomerulonephritis, often with accompanying clinical picture of proteinuria and nephrotic syndrome, hematuria and progressive decrease in decrease in the glomerular filtration rate (GFR). In some cases, however, the course is rapid and leads to acute renal failure. The disease such as systemic lupus also causes numerous changes in the nervous system, which may be in various manifestations. The frequency of neurological involvement is almost as high as nephropathy. One of the rare symptoms, in addition to depression, cognitive disorders, disturbances of consciousness, is the occurrence of changes in the peripheral nervous system in the form of neuropathy (mononeuropathy or polyneuropathy) and even damage to the entire nerve plexus (plexopathy). Treatment of all complications, and the primary disease, especially in the case of renal dysfunction, may be a therapeutic challenge. Below is a description of a patient with chronic kidney disease stage 5 in the course of systemic lupus erythematosus, in whom neuropathic pain was successfully managed with gabapentinoids.