Sensory ganglionopathy and pituitary lesion in systemic lupus erythematosus: A case report and literature review

Background. Systemic lupus erythematosus (SLE) rarely manifests as sensory ganglionopathy or pituitary lesions, posing diagnostic challenges due to their atypical presentations and potential for irreversible damage. Case presentation. A 26-year-old male presented with five months of gait instability, numbness, and hand clumsiness, along with dry eyes and loose stools. Examination revealed sensory ataxia, absent reflexes, and positive anti-dsDNA antibodies, confirming SLE. Nerve conduction studies showed absent sensory nerve action potentials, consistent with sensory ganglionopathy. MRI identified a non-enhancing pituitary lesion suggestive of autoimmune hypophysitis, with associated hyperprolactinemia and hypogonadism. Treatment with methylprednisolone, oral steroids, and cabergoline stabilized the patient’s symptoms without further progression. Conclusion. Early recognition of sensory ganglionopathy and pituitary involvement in SLE is critical to prevent irreversible neuronal and endocrine damage through timely immunosuppression.