Case Report
Seizures and Guillain-Barré Syndrome Leading to the Discovery of Systemic Lupus: Case of an Adolescent in Lomé and Review of the Literature
Issue:
Volume 14, Issue 3, September 2026
Pages:
47-56
Received:
7 May 2026
Accepted:
22 May 2026
Published:
17 July 2026
DOI:
10.11648/j.ajpn.20261403.11
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Abstract: Background: Systemic lupus erythematosus (SLE) is a chronic idiopathic autoimmune disease. Guillain-Barré syndrome (GBS) is an acute monophasic immune-mediated polyradiculoneuropathy. Case presentation: We report the case of a 16-year-old patient, who presented in November 2023 a flu-like syndrome with diarrhea and abdominal pain. Then he had visual hallucinations and psychosis, followed by generalized tonic-clonic seizures. Urine toxicology assay was positive, a syndrome of hepatic cytolysis and cholestasis were noted. Toxic encephalopathy and hepatopathy were mentioned and he was transferred to a psychiatric ward where he persisted with an infectious syndrome, hallucinations, delirium and then flaccid tetraplegia of ascending evolution with dyspnea and respiratory distress. In January 2024, there was tetraplegia, abolished deep tendon reflexes (DTR) in all 4 limbs, hypoesthesia in all 4 limbs. Cerebrospinal fluid examination found albumin -cytological dissociation. Magnetic resonance imaging of the spinal cord was normal. He received 500 mg of intravenous methylprednisolone for 3 days then a per os relay with prednisolone 50 mg in addition to azathioprine (Aza) 50 mg x2/day and functional rehabilitation. The electroencephalogram revealed signs of non-structural generalised epilepsy in March 2024. The electroneuromyogram found a neurophysiological pattern of acute polyradiculoneuropathy in the recovery phase. In the evolution, an antinuclear antibody assay (indirect immunofluorescence) came back positive at a titer of 1/160, with a speckled appearance. On the basis of the American College of Rhumatology (ACR) with a score of 19, the diagnosis of SLE was retained and background treatment with Aza 50 mg/day continued. At the end of May 2025, there persisted a predominantly distal tetraparesis, an abolition of DTR. Conclusion: Although rare, GBS can be the mode of revelation of SLE. This SLE-GBS association is often serious and can be life-threatening.
Abstract: Background: Systemic lupus erythematosus (SLE) is a chronic idiopathic autoimmune disease. Guillain-Barré syndrome (GBS) is an acute monophasic immune-mediated polyradiculoneuropathy. Case presentation: We report the case of a 16-year-old patient, who presented in November 2023 a flu-like syndrome with diarrhea and abdominal pain. Then he had visua...
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,
Kokou Mensah Guinhouya
