Korean J Med.  2012 Nov;83(5):683-687.

A Case of Miller Fisher Syndrome in a Patient with Systemic Lupus Erythematosus

• Lee YK
• Park YH
• Choi A
• Lee CH
• Cho JH
• Kim HY
• Yoon PH

Abstract

Neuropsychiatric events are common in patients with systemic lupus erythematosus (SLE). The estimated incidence of neuropsychiatric SLE (NPSLE) is 30 to 40%. However, NPSLE poses a difficult diagnostic challenge because a variety of conditions should be considered in the differential diagnosis, especially when patients present with uncommon or rare NPSLE features. We herein describe a 49-year-old man with SLE who initially presented with diplopia, ptosis, and gait disturbance that had developed 1 week after an upper respiratory tract infection. He was finally diagnosed with Miller Fisher syndrome (a variant of Guillain-Barre syndrome) according to clinical symptoms, anti-GQ1b antibody positivity, and neurological study results. The patient recovered without sequelae with intravenous immunoglobulin therapy. This is the first report to describe a case of Miller Fisher syndrome that developed in a patient with SLE in Korea and suggests that Miller Fisher syndrome should be included as a differential diagnosis of NPSLE.

Keyword

Anti-GQ1b antibody; Miller Fisher syndrome; Systemic lupus erythematosus

MeSH Terms

Diagnosis, Differential
Diplopia
Gait
Humans
Immunization, Passive
Incidence
Korea
Lupus Erythematosus, Systemic
Middle Aged
Miller Fisher Syndrome
Respiratory Tract Infections