Abstract
AimTo study clinical, electrophysiological, and laboratory properties of peripheral neuropathy (PN) in systemic lupus erythematosus (SLE) and their association with disease activity.Patients and methodsA totalof 30 patients who met the American College of Rheumatology case definition criteria for SLE-PN and 30 age-matched and sex-matched patients with SLE without PN were selected from the Main Alexandria University Hospital Physical Medicine, Rheumatology and Rehabilitation clinic. Demographic data, SLE-related clinical, laboratory data, Systemic Lupus Activity Measure (SLAM) index, and nerve conduction studies were done. This case–control study compared clinical and SLE-related features, laboratory, and SLAM index in patients with SLE with PN versus those without neuropathy.ResultsThe results showed that the most common PN subtype was sensorimotor polyneuropathy which occurred in 18 (60%) patients; the most common PN pathology was axonal degeneration, which occurred 19 (63.3%) patients; and the most common associated nerve entrapment was carpal tunnel syndrome in 10 (33.3%) patients. In comparison between group I (SLE with PN) and group II (SLE without PN), there was no statistically significant difference between the two groups regarding demographic data, disease duration, and lupus clinical features, except malar rash and lupus nephritis, which showed significant increase in patients with SLE with PN compared with patients with SLE without PN (P=0.003 and P<0.001, respectively). There was no statistically significant difference among PN subtype groups regarding sex, age, and immunological markers. Regarding diseases activity, SLAM index showed a significant increase in patients with SLE with PN compared with patients with SLE without PN (P=0.006).ConclusionThe pattern of neuropathy in SLE is mainly axonal. Moreover, the most common PN subtype is sensorimotor polyneuropathy. The study suggests significant association of PN in patients with SLE with nephritis, malar rash, and SLAM index.
Highlights
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder with wide scope of clinical introductions
The American College of Rheumatology proposed case definitions and classification criteria for 19 central nervous system (CNS) and peripheral nervous system (PNS) syndromes observed in SLE [1]
The clinical presentation of Peripheral neuropathy (PN) relies upon the diameter of the affected nerve, the sort of demyelinating or axonal lesions, and their acute or chronic occurrence [11]
Summary
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder with wide scope of clinical introductions. It affects both the central nervous system (CNS) and the peripheral nervous system (PNS). Unique sorts of neuropathy happen in SLE, including symmetrical polyneuropathy, mononeuropathy, and cranial neuropathy [1,3,5,6]; in addition, other dysimmune neuropathies, including (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), as well as neuropathies owing to non-SLE causes, for example, nerve entanglement or other related clutters, are found in patients with SLE [7,8] In perspective on this heterogeneity, it is obvious that the revealed commonness of neuropathy in SLE has been variable [9,10]. Because of contrasts in the criteria used to characterize neuropathy, regardless of whether clinical or electrophysiological, studies that have fundamentally utilized electrophysiological criteria for neuropathy have frequently revealed higher prevalence
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