Clinical Report: Coexisting Multiple Sclerosis and Neuropsychiatric Systemic Lupus Erythematosus

Overview

This case study presents a 69-year-old female patient initially misdiagnosed with depression, who was later diagnosed with coexisting multiple sclerosis (MS) and neuropsychiatric systemic lupus erythematosus (NPSLE).

Background

The overlap of autoimmune central nervous system disorders poses significant diagnostic challenges, particularly in distinguishing between conditions like MS and MOG-IgG-associated disorder (MOGAD). Accurate diagnosis is crucial for appropriate management and treatment.

Data Highlights

Key Findings

• The patient was initially diagnosed with major depressive disorder but later developed neurological symptoms.
• Brain MRI revealed multifocal white matter lesions consistent with demyelination.
• Serologic testing showed positivity for multiple autoantibodies, including MOG-IgG.
• CSF examination confirmed intrathecal IgG synthesis with oligoclonal bands.
• The patient improved clinically after treatment with glucocorticoids and hydroxychloroquine.

Clinical Implications

This case highlights the need for thorough evaluation in patients with psychiatric symptoms to rule out underlying neurological disorders.

Conclusion

The coexistence of MS and NPSLE in this patient illustrates the complexities of diagnosing overlapping autoimmune disorders.

Related Resources & Content

1. Frontiers in Immunology, 2026 -- Triple antibody-associated autoimmune encephalitis overlap: a case report of co-existing MOG-IgG, anti-NMDAR, and anti-mGluR5 positivity
2. Acta Neuropathologica, 2020 -- Pathological Insights into Inflammatory Demyelinating Disorders of the Central Nervous System Associated with Myelin Oligodendrocyte Glycoprotein Autoantibodies
3. Frontiers in Immunology, 2026 -- Myelin oligodendrocyte glycoprotein antibody-associated disease presenting as encephalitis and concurrent Epstein-Barr virus detection: a case series
4. Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria - PubMed
5. Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): Practical recommendations for diagnosis and management - PubMed
6. Frontiers in Immunology — Anti-NMDAR and anti-MOG antibody double-positive encephalitis temporally associated with cytomegalovirus detection in cerebrospinal fluid: a case report
7. New Lupus SLE Clinical Practice Guideline Released | ACR Convergence 2025 | American College of Rheumatology
8. Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria - PubMed
9. Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): Practical recommendations for diagnosis and management - PubMed