Obturator neuropathy from SLE lymphadenopathy: an interdisciplinary diagnostic challenge

Area of Science:

• Rheumatology
• Neurology
• Radiology

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune disease.
• Uncommon presentations of SLE require thorough investigation.

Purpose of the Study:

• To report an unusual cause of thigh myopathy and nerve compression in a patient with SLE.
• To highlight the importance of interdisciplinary collaboration in diagnosing and managing complex autoimmune conditions.

Main Methods:

• A case study of a 26-year-old woman with a 10-year history of SLE presenting with thigh pain and hip mobility restriction.
• Diagnostic workup included MRI, histopathological, and neurological examinations.
• Pelvic MRI revealed bilateral lymphadenopathy compressing the obturator nerve.

Main Results:

• High-dose prednisolone treatment resulted in rapid clinical improvement, pain resolution, and restored hip mobility.
• Radiological evidence showed resolution of muscular and nodal changes.

Conclusions:

• This case illustrates an uncommon manifestation of active SLE involving pelvic lymphadenopathy leading to obturator nerve compression and secondary thigh myopathy.
• Early interdisciplinary evaluation is critical for effective diagnosis and management of such complex autoimmune presentations.