Systemic Lupus and Polyneuropathy

Lewis, David C.

doi:10.1001/archinte.1965.03870040032008

Cited by 18 publications

(6 citation statements)

References 22 publications

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“…We are certainly not the first to report a distal symmetrical polyneuropathy in the setting of collagen vascular diseases including classic polyarteritis nodosa 11 7,23,28,31,331, rheumatoid arthritis [5, 21,22, 26, 35, 44, 461, and systemic lupus erythematosus [3,11,20,24,25,27,30,431. However, it is difficult to determine the pathogenesis of the nerve changes in many of these previous reports, as nerve biopsies frequently were not done, and in other cases the neuropathic condition was said to be secondary to a demyelinating, toxic, or metabolic process [l, 19, 20, 30f.…”

Section: Discussionmentioning

confidence: 99%

The clinical spectrum of necrotizing angiopathy of the peripheral nervous system

Kissel

Slivka

Warmolts

et al. 1985

Annals of Neurology

161

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The peripheral neuropathy seen with necrotizing angiopathy is said to begin classically as a mononeuritis multiplex, usually associated with polyarteritis nodosa, rheumatoid arthritis, or systemic lupus erythematosus. Our experience, however, suggests that a large number of these patients do not have a well-defined collagen vascular disease or the typical clinical pattern. In 350 consecutive nerve biopsies (sural or superficial radial), 16 patients showed a necrotizing angiopathy in the epineurial blood vessels. Six of these 16 patients had a distal symmetrical sensorimotor polyneuropathy. The remaining 10 had a mononeuritis multiplex, although in 8 overlapping nerve involvement somewhat obscured the picture of mononeuritis. In 12 patients, no specific underlying collagen vascular disease could be diagnosed by accepted criteria despite extensive clinical, radiological, and serological evaluations. The peripheral neuropathy was the only objective evidence of vasculitis in 7 of these 12 patients. Our findings suggest that patients with a peripheral neuropathy secondary to necrotizing angiopathy often do not have a definable collagen vascular disease. In fact, peripheral neuropathy may be the sole manifestation of vasculitis. Furthermore, the neuropathy was found to be a distal symmetrical sensorimotor neuropathy in a higher proportion of cases than has been documented previously.

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Section: Discussionmentioning

confidence: 99%

The clinical spectrum of necrotizing angiopathy of the peripheral nervous system

Kissel

Slivka

Warmolts

et al. 1985

Annals of Neurology

161

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“…They may present as symmetrical motor, sensory, or mixed deficits of acute onset resembling the Guillain-Barr6 syndrome [32], or their onset may be more insidious [22,53]. Pathological studies have shown abnormalities of vessels supplying the peripheral nerve in some cases [5,42], but demyelination in the absence of demonstrable vasculopathy has been described frequently [32,46] and might better explain the clinical picture [46].…”

Section: Clinical Featuresmentioning

confidence: 99%

Cerebral disease in systemic lupus erythematosus

Harris

Hughes

1985

Springer Semin Immunopathol

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“…As in our patient, the response of SLE-associated PRN to corticosteroids seems inconstant: among the eight patients reported in the literature for whom the outcome was available, seven received corticosteroids, and four died (5)(6)(7)(8). Plasma exchange has been shown to be effective in primary GBS (1 l), but this treatment has never been tried in SLE-associated PRN and is potentially dangerous in elderly patients with severe conditions.…”

Section: Discussionmentioning

confidence: 58%

Prolonged Remission of SLE-associated Polyradiculoneuropathy after a Single Course of Intravenous Immunoglobulin

Lesprit¹,

Mouloud²,

Bierling

et al. 1996

Scandinavian Journal of Rheumatology

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Polyradiculoneuropathy is a rare and potentially severe complication of systemic lupus erythematosus (SLE). Treatment is not codified and response to corticosteroid is inconstant. We report the case of a patient with severe SLE-associated polyradiculoneuropathy and autoimmune thrombocytopenia. Dramatic neurologic improvement and correction of thrombocytopenia were observed after a single course of high-dose intravenous immunoglobulin infusions (IVIg, 2g/kg body weight). Our case suggests that IVIg may be effective in the treatment of this unusual condition.

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Systemic Lupus and Polyneuropathy

Cited by 18 publications

References 22 publications

The clinical spectrum of necrotizing angiopathy of the peripheral nervous system

The clinical spectrum of necrotizing angiopathy of the peripheral nervous system

Cerebral disease in systemic lupus erythematosus

Prolonged Remission of SLE-associated Polyradiculoneuropathy after a Single Course of Intravenous Immunoglobulin

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