Recurrent brachial plexopathy as initial presentation of systemic lupus erythematosus: A case report and review of the literature.

Ahmed M El-Dokla, Eduardo Bonilla, Sara Ali, Andras Perl

Journal: Lupus 2022;31(4):500-504

PMID: 35259024

Abstract

BACKGROUND

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects many organs of the body including the peripheral nervous system (PNS) which has potential significant impact. Plexopathy is rare but one of the serious PNS manifestations of lupus.

CASE

A 41-year-old female presented with recurrent attacks of painful brachial plexopathy and right hemi-diaphragmatic paralysis. After extensive workup, she was diagnosed with SLE and started on hydroxychloroquine and mycophenolate mofetil. The frequency and severity of the attacks of plexopathy has significantly improved after starting the immune suppressive therapy for SLE. Whole exome sequencing unveiled previously unreported mutations encoding non-synonymous amino acids in titin and minichromosome maintenance 3-associated protein.

CONCLUSION

Recurrent attacks of painful brachial plexopathy may warrant careful evaluation for underlying SLE with a premise of therapeutic benefit.

Address: Department of Neurology, 12302University of New York, Upstate Medical University, Syracuse, NY, USA.; Department of Pathology, State University of New York, 12302Upstate Medical University, Syracuse, NY, USA.; Department of Medicine, State University of New York, 12302Upstate Medical University, Syracuse, NY, USA.; Department of Neurology, 12302University of New York, Upstate Medical University, Syracuse, NY, USA.

DOI: 10.1177/09612033221086127

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MeSH Terms: Adult, Brachial Plexus Neuropathies, Female, Humans, Hydroxychloroquine, Lupus Erythematosus, Systemic, Mycophenolic Acid, Peripheral Nervous System