Vol. 11, No.

4, December, 2004

= Abstract =

A Case of Systemic Lupus Erythematosus

Presenting as Mononeuritis Multiplex
Su-Hyun Kim, M.D., Ji-Eun Chang, M.D., Jisoo Lee, M.D.
Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
Mononeuritis multiplex is a peripheral neuropathy characterized by degeneration of one or
more named nerve trunks in association with the systemic vasculitides. Mononeuritis multiplex
occurs rarely in systemic lupus erythematosus (SLE) patients and usually develops as a late
complication of the disease. When mononeuritis multiplex occurs as a presenting feature of SLE,
the diagnosis is often delayed causing considerable morbidity. We describe a patient who
presented with mononeuritis multiplex as an initial manifestation of SLE.

Key Words: Mononeuritis multiplex, Systemic lupus erythematosus

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2004 3 15, 2004 9 20

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E-mailleejisoo@mm.ewha.ac.kr

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TOENNIES
No. Stim site/Rec site
A
B
C
D
E
F

N
N
N
N
N
N

tibialis right / PFd-PFp

tibialis right / T12-Ic
tibialis right / Cz-Fz
tibialis right / PFd-PFp
tibialis right / T12-Ic
tibialis right / Cz-Fz

mA

ms/Div

uV/Div

55
55
55
0
0
0

10.0
10.0
10.0
10.0
10.0
10.0

8.00
4.00
1.60
8.00
4.00
1.60

TOENNIES

iweeps/Rejec

No. Stim site/Rec site

300 / 37 ~
300 / 37 ~
300 / 37 ~
501 / 192 ~
501 / 192 ~
501 / 192 ~

G N tibialis left / PF d-PFp

H N tibialis left / T12-Ic
J N tibialis left / PFd -PFp
K N tibialis left / T12-Ic
L N tibialis left / Cz-Fz

mA

ms/Div

uV/Div

25
25
25
25
25

10.0
10.0
10.0
10.0
10.0
10.0

4.00
4.00
1.60
8.00
4.00
1.60

iweeps/Rejec
550 / 14 ~
550 / 14 ~
550 / 14 ~
410 / 80 ~
410 / 80 ~
410 / 80 ~

Fig. 1. Nerve conduction velocity (A) Right (B) Left. Both of N. fibularis and N. tibialis, Right were shown as
compound motor-action potential, at the both of N. fibularis, sensory nerve action potentials were not
developed, and at the SEP (skin-stimulation evoked potential), popliteal fossa potential was not shown with
delayed cortical latency.

399

 11

4 2004

Euro-Lupus Nephritis Trial

cyclophosphamide 500 mg 2 6

: 8.9 mg/dL,
3

27.8%, 3,800/mm ( 64%,

3

3), calcort 6 mg
azathoiprine 100 mg

17%), 48,000/mm .

48 mm/hr, C 3.5 mg/dL.

7.0 g/dL, 3.3 g/dL,

Glucose 91 mg/dL, BUN 22 mg/dL, Creatinine 0.7

mg/dL, AST 13 IU/L, ALT 9 IU/L. ,

. C3, C4 107 mg/dL, 14.6

mg/dL .

(1320, speckled type) . Lupus an-

ticoagulant 48.5 sec (: 3144 sec)

, ,

cardiolipin . ANCA,

DNA, Sm , SSA , SSB , RNP

4)

, ,

( 1).

. Hellmann

36%

.
:

1).

Tc99m

31% , 22%

: , ,

( , ), ANA

1).

cyclophosphamide

500 mg 1 g

221%

. cyclophosphamide

, , ,

( 81.1%, 14.1%),

5-8).

173,000/mm

. 3

Feinglass 15

9,600/mm

400

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19% 1.5%

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cyclophosphamide

sphamide 9).

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10).

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.
Yoshikawa
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