Since 1961, the overlap between myasthenia gravis (MG) and systemic lupus erythematosus (SLE) has been increasingly recognized, with MG patients facing up to 13 times the risk of developing SLE, especially after thymectomy, predominantly in young women. Thymic B cells may play a role in MG and SLE, as shown in animal models. MG often coexists with family histories of autoimmune diseases, sharing genetic risk factors with SLE, as supported by genome-wide studies. Patients with both conditions also experience higher rates of other autoimmune diseases, suggesting a potential for broader autoimmunity. Early-onset MuSK-MG strengthens this observed connection.
autoinmunidad
Parkinsonismo y deterioro cognitivo rápidamente progresivo en un paciente con lupus eritematoso sistémico y síndrome antifosfolípido triple positivo. Parkinsonism and rapidly progressive cognitive decline in a patient with systemic lupus erythematosus and triple-positive antiphospholipid syndrome.
Background: The association between parkinsonism and systemic lupus erythematosus is inadequately described, and to date, the underlying pathophysiological mechanisms are not fully established, ranging from vascular impairments to immunomediated phenomena. Literature analysis identified only 28 cases of parkinsonism in patients with systemic lupus erythematosus, underscoring the limited attention to these associations and their respective therapeutic approaches.
Case Report: We present a case of a patient with an atypical presentation of systemic lupus erythematosus and a diagnosis of triple-positive antiphospholipid syndrome. Despite the absence of lupus activity, the patient developed symptoms of parkinsonism and rapidly progressive cognitive decline. No other underlying causes or thrombotic events in brain imaging were found to explain the atypical clinical presentation. Simultaneous administration of immunosuppressive therapy and levodopa/carbidopa resulted in symptom improvement.
Conclusion: Insufficient research has been conducted on the correlation between systemic lupus erythematosus and parkinsonism, primarily due to its seemingly low incidence in the medical literature. Consequently, this case report offers additional insights into this association, potentially laying the groundwork for future structured and well-designed studies. The efficacy of levodopa and immunosuppressive therapy in treating these patients remains uncertain and necessitates further investigation.
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Palabras clave: autoinmunidad,
lupus eritematoso sistémico,
parkinsonismo,
Síndrome antifosfolípido,
