Small fiber neuropathy and related factors in patients with systemic lupus erythematosus; the results of cutaneous silent period and skin biopsy

Aslan Tekatas,Volkan Solmaz,Turan Karaca,Demet Deniz Tekatas,Omer Nuri Pamuk

doi:10.1186/s42358-020-00133-9

Aslan Tekatas, Volkan Solmaz + Show 3 more

Open Access

https://doi.org/10.1186/s42358-020-00133-9

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Abstract

IntroductionEvaluating small nerve fibers in patients with systemic lupus erythematosus (SLE) using cutaneous silent period (CSP) and skin biopsy and assesssing the relationship between clinical signs, autoantibodies and neuropathic pain score.Objective – methodsFifty one SLE patients and 46 healthy volunteers were included in this study. Nerve conduction studies and CSP were performed both on upper and lower limbs in subjects. Skin biopsy was performed and the number of epidermal nerve density and IL-6 staining were evaluated.ResultsIn SLE patients, CSP latencies were significantly prolonged both in lower and upper limbs and lower and upper extremity CSP durations were significantly shorter when compared to controls (p < 0.001). The number of epidermal nerve was significantly lower in SLE patients when compared to healthy controls (p < 0.001).ConclusionWe detected marked small nerve fiber damage in both lower and upper limbs in SLE patients using CSP. Decreased epidermal nerve density also supports this finding.

Highlights

Evaluating small nerve fibers in patients with systemic lupus erythematosus (SLE) using cutaneous silent period (CSP) and skin biopsy and assesssing the relationship between clinical signs, autoantibodies and neuropathic pain score
In SLE patients, CSP latencies were significantly prolonged both in lower and upper limbs and lower and upper extremity CSP durations were significantly shorter when compared to controls (p < 0.001)
Some SLE patients suffer neuropathic symptoms suchs as pain, numbness and burning feeling more when compared to healthy volunteers, but they do not have any neurologic involvement signs corresponding to these symptoms

Summary

Introduction

Evaluating small nerve fibers in patients with systemic lupus erythematosus (SLE) using cutaneous silent period (CSP) and skin biopsy and assesssing the relationship between clinical signs, autoantibodies and neuropathic pain score. Systemic lupus erythematosus (SLE) is chronic inflammatory autoimmune disease affecting many organs, characterized by autoantibody and immune complex production against nuclear antibodies [1]. There have been many studies evaluating clinical findings and possible mechanisms about central nervous system (CNS) involvement in SLE patients. Frequency of peripheral neuropathy in SLE patients has been reported as 10–20% varying in different studies [2, 3]. Some SLE patients suffer neuropathic symptoms suchs as pain, numbness and burning feeling more when compared to healthy volunteers, but they do not have any neurologic involvement signs corresponding to these symptoms. It is known that some sensorial and sensorimotor polyneuropathies starts with the involvement of small fiber and the large fibers are affected [5]

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