ABSTRACT
We report a case of systemic lupus erythematosus (SLE), in a 48-year-old woman, a known hypertensive and recently diagnoseddiabetic, with a predominant complain of acute onset bilateral lower limb weakness and loss of sensation of the bilateral palmand soles with bowel incontinence and excessive hair loss. On evaluation, her vitals were stable, cardiovascular, respiratory,and abdominal systemic examination revealed no significant abnormality. Neurological examination revealed a normal tone withdistal muscle weakness more in the lower limb than in the upper limb. She was thoroughly evaluated for the above-mentionedcomplaints and examination findings. Nerve conduction study was done - which revealed upper limb - severe asymmetric motorsensory neuropathy - axonal type and lower limb - axonal symmetrical severe polyradiculoneuropathy. Nerve biopsy revealed avasculitic neuropathy. Autoimmune workup was positive for antinuclear antibodies, and low C3 levels, with direct Coombs testpositive, increased UPCR ratio. According to the Systemic Lupus International Collaborating Clinic criteria, she was diagnosedwith SLE. Hence, this is a case of SLE, with a primary presentation of a vasculitic neuropathy, an unusual occurrence.