{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:08:53Z","timestamp":1784034533809,"version":"3.55.0"},"reference-count":10,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2025,10,28]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>A 31-year-old woman presented with generalised pain and weakness due to a severe axonal sensorimotor neuropathy, rapidly worsening over 2 weeks. For 6 months she had experienced transient joint symptoms, rash and hair loss. A vasculitic process was considered. Blood tests taken following intravenous immunoglobulin (IVIG) (given for suspected Guillain\u2013Barr\u00e9 syndrome) noted strongly positive lupus and antiphospholipid antibody titres. She was diagnosed with severe multisystem lupus vasculitis involving the central and peripheral nervous system and started on cyclophosphamide and prednisolone, with notable improvement. We outline challenges faced in this patient\u2019s care, including making the diagnosis, interpreting autoantibody serology following IVIG treatment and identifying suitable immunosuppression regimens in a limited evidence base. It is important to be aware that peripheral neuropathy is an under-recognised presenting manifestation of neurological lupus.<\/jats:p>","DOI":"10.1136\/pn-2025-004879","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T19:00:18Z","timestamp":1763665218000},"page":"366-372","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Severe lupus vasculitic neuropathy"],"prefix":"10.1136","volume":"26","author":[{"given":"Apoorva Anil","family":"Kumar","sequence":"first","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Jia Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carine J","family":"Moezinia","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Levy","sequence":"additional","affiliation":[{"name":"Croydon University Hospital, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3787-0531","authenticated-orcid":false,"given":"Fernanda","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Division of Neuropathology, National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Brandner","sequence":"additional","affiliation":[{"name":"Division of Neuropathology, National Hospital for Neurology and Neurosurgery, London, UK"},{"name":"Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick","family":"Schon","sequence":"additional","affiliation":[{"name":"Croydon University Hospital, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Modarres","sequence":"additional","affiliation":[{"name":"Croydon University Hospital, London, England, UK"},{"name":"Neurophysiology, Croydon University Hospital, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander M","family":"Rossor","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, London, UK"},{"name":"Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"2026071405250891000_26.4.366.1","first-page":"330","article-title":"Manifestations of systemic lupus 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