A Rare Coexistence: Minimal Change Disease and Guillain-Barre Syndrome in a Patient with Polysubstance Abuse

Introduction: Minimal Change Disease (MCD) and Guillain-Barre Syndrome (GBS) are distinct clinical entities with unique pathophysiological mechanisms. MCD, characterized by nephrotic syndrome and podocyte effacement on renal biopsy, is commonly associated with autoimmune disorders and certain medications. GBS, on the other hand, is an acute autoimmune neuropathy leading to ascending motor weakness and areflexia. Here, we present a rare case of concurrent MCD and GBS in a patient with a history of polysubstance abuse. Case Description: A 50-year-old female with a past medical history of heart failure with reduced ejection fraction (HFrEF), polysubstance abuse, and untreated hypothyroidism presented with worsening shortness of breath, vomiting, and hyperbilirubinemia. Evaluation revealed acute kidney injury, likely exacerbated by congestive heart failure, and bilateral tibial axonal motor neuropathy consistent with GBS. Further investigations confirmed a diagnosis of MCD based on renal biopsy findings. Discussion: The coexistence of MCD and GBS in this patient highlights the importance of considering multiple etiologies in individuals with complex medical histories, particularly those with a history of polysubstance abuse. The underlying mechanisms linking these two conditions remain unclear but warrant further investigation. Management requires a multidisciplinary approach, addressing both renal and neurological manifestations to optimize patient outcomes.