Systemic lupus erythematosus is easily misdiagnosed as subacute combined degeneration

Abstract

Background and objective: Systemic lupus erythematosus is likely the cause of neurological dysfunction manifested as subacute combined degeneration. The objective of this article is to report the clinical manifestation of systemic lupus erythematosus manifested as subacute combined degeneration. Methods: We retrospectively analyzed the clinical data of a 37-year-old female patient with systemic lupus erythematosus accompanied by subacute combined degeneration who received treatment at Shenzhen People's Hospital, China. This study met the requirements of the Declaration of Helsinki and the patient gave informed consent. Results: The patient initially presented the symptoms of numbness and weakness of both upper and lower limbs and urinary retention. The patient's physical signs involved peripheral nerve, and posterior and lateral columns of the spinal cord. Blood test revealed anemia and low folate level. Her clinical manifestation was consistent with subacute combined degeneration. But serum antinuclear antibodies (ANA), anti-double-stranded DNA (anti-dsDNA) antibodies, anti-Ro/Sjögren's antibodies (anti-Ro/SSA) and anti-La/Sjögren's antibodies (anti-La/SSB) were found to be positive. Finally, the diagnosis of systemic lupus erythematosus was considered. Conclusion: Systemic lupus erythematosus can cause a variety of neurological defect symptoms, especially in female patients. Tests for autoantibodies should be performed to reduce misdiagnosis rate.