Therapeutic Plasma Exchange in a Patient With Acute Motor Axonal Neuropathy Subtype of Guillain-Barre Syndrome and Systemic Lupus Erythematosus

Objective To highlight treatment resistance of concurrent Guillain-Barre syndrome (GBS) and active systemic lupus erythematosus (SLE). Background Coincidence SLE GBS is an uncommon complicated course autoimmune disease. Treatment further by pregnancy exacerbation SLE. Design/Methods We report a case acute motor axonal neuropathy (AMAN) subtype in young pregnant woman her early 20s presenting with Patient was 10 weeks at presentation. Lumbar puncture study electrical muscle stimulation (EMS) were consistent GBS. also had increased proteinuria renal biopsy performed that nephritis. Despite IVIG pulse dose corticosteroids, the patient minimal neurological improvement respiratory decline requiring intubation. Her terminated this point therapeutic plasma exchange (TPE) started followed cyclophosphamide. Results The responded to combination therapy slow but gradual neurologic recovery as well proteinuria. Conclusions Concurrent setting may be more resistant, including TPE, immunosuppression, termination indicated. For patients SLE, especially during pregnancy, TPE should considered primary option respect both efficacy safety.