Rivera-Lizárraga DA, Jiménez-González JC, Solís-Gamboa MI, Espinosa-Padilla SE, Gutiérrez-Hernández JA, Yamazaki-Nakashimada MA, Rivas-Larrauri FE, Bustamante-Ogando JC

Language: Spanish
References: 21
Page: 27-32
PDF size: 239.03 Kb.

ABSTRACT

Introduction: systemic lupus erythematosus (SLE) is a multisystem disease with heterogeneous manifestations caused by autoantibodies and immune complexes. Guillain-Barré syndrome (GBS) as the main manifestation of pediatric SLE is extremely rare and does not respond to conventional treatment. Clinical case: the case of a female adolescent with progressive, ascending, symmetrical decrease in strength is described, until developing respiratory failure. Nerve conduction tests corresponds to mixed polyradiculopathy, treated with intravenous immunoglobulin at 2 g/kg single dose, without improvement. Patient presented hypertension and proteinuria, so an approach for underlying autoimmune disease was initiated, founding hypocomplementemia, antinuclear antibodieas ++ (homogeneous pattern), anti-La and anti-Ro antibodies positive, fulfilling 12 points of the EULAR/SLE classification criteria. five plasma exchanges, three steroid pulses, four doses of rituximab and immunosuppression with mofetil mycophenolate, achieving improvement. Conclusion: in all patients with GBS with poor response to conventional treatment, another underlying autoimmune disease must be intentionally sought, in order to establish adequate and timely treatment with a reduction in complications.

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