Tags

Type your tag names separated by a space and hit enter

Vasculitic Peripheral Neuropathy, Differences Between Systemic and Non-Systemic Etiologies: A Case Series and Biopsy Report.
J Neuromuscul Dis. 2020 Oct 19 [Online ahead of print]JN

Abstract

BACKGROUND

Vasculitic peripheral neuropathy (VPN) is caused by vessel inflammation leading to peripheral nerve injury of acute-to-subacute onset. When VPN occurs in the context of systemic disease it is classified as Systemic Vasculitic Neuropathy (SVN) and as Non-Systemic Vasculitic Neuropathy (NSVN) when restricted to the nerves.

OBJECTIVE

This study aimed to compare the clinical characteristics, biopsy findings and disease outcome in patients with VPN.

METHODS

Clinical records of adult patients with VPN diagnosed at our institution between June-2002 and June-2019 were retrospectively reviewed. Demographic characteristics, clinical manifestations, nerve conduction studies, nerve biopsies, treatment and clinical evolution were analyzed in all patients with at least 6 months follow-up.

RESULTS

Twenty-five patients with VPN were included (SVN, n = 10; NSVN, n = 15). No significant differences in demographic or clinical features were found between groups. The median delay between symptom onset and nerve biopsy was significantly longer in NSVN patients (10 vs 5.5 months, p = 0.009). Erythrocyte sedimentation rate (ESR) values over 20 mm/h were significantly more common in SVN patients (100% vs. 60%, p = 0.024). Nerve biopsies showed active lesions more frequently in treatment-naive patients compared to those who had received at least 2 weeks of corticosteroids (92% vs 38%; p = 0.03), with a higher proportion of definite VPN cases (92 vs 46%; p = 0.04).

CONCLUSIONS

Although the clinical manifestations are similar, ESR is an important tool to help distinguish between both conditions. Early nerve biopsy in untreated patients increases diagnostic accuracy, avoiding misdiagnosis.

Authors+Show Affiliations

Neurology department, FLENI, Buenos Aires, Argentina.Neurology department, FLENI, Buenos Aires, Argentina.Neurology department, FLENI, Buenos Aires, Argentina.Neuropathology department, FLENI, Buenos Aires, Argentina.Neurology department, FLENI, Buenos Aires, Argentina.Neurology department, FLENI, Buenos Aires, Argentina.Neurology department, FLENI, Buenos Aires, Argentina.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33104037

Citation

Castiglione, J I., et al. "Vasculitic Peripheral Neuropathy, Differences Between Systemic and Non-Systemic Etiologies: a Case Series and Biopsy Report." Journal of Neuromuscular Diseases, 2020.
Castiglione JI, Marrodan M, Alessandro L, et al. Vasculitic Peripheral Neuropathy, Differences Between Systemic and Non-Systemic Etiologies: A Case Series and Biopsy Report. J Neuromuscul Dis. 2020.
Castiglione, J. I., Marrodan, M., Alessandro, L., Taratuto, A. L., Brand, P., Nogués, M., & Barroso, F. (2020). Vasculitic Peripheral Neuropathy, Differences Between Systemic and Non-Systemic Etiologies: A Case Series and Biopsy Report. Journal of Neuromuscular Diseases. https://doi.org/10.3233/JND-200576
Castiglione JI, et al. Vasculitic Peripheral Neuropathy, Differences Between Systemic and Non-Systemic Etiologies: a Case Series and Biopsy Report. J Neuromuscul Dis. 2020 Oct 19; PubMed PMID: 33104037.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vasculitic Peripheral Neuropathy, Differences Between Systemic and Non-Systemic Etiologies: A Case Series and Biopsy Report. AU - Castiglione,J I, AU - Marrodan,M, AU - Alessandro,L, AU - Taratuto,A L, AU - Brand,P, AU - Nogués,M, AU - Barroso,F, Y1 - 2020/10/19/ PY - 2020/10/26/entrez PY - 2020/10/27/pubmed PY - 2020/10/27/medline KW - Vasculitic peripheral neuropathy (VPN) KW - nerve biopsy KW - non-systemic vasculitic neuropathy (NSVN) KW - systemic vasculitic neuropathy (SVN) JF - Journal of neuromuscular diseases JO - J Neuromuscul Dis N2 - BACKGROUND: Vasculitic peripheral neuropathy (VPN) is caused by vessel inflammation leading to peripheral nerve injury of acute-to-subacute onset. When VPN occurs in the context of systemic disease it is classified as Systemic Vasculitic Neuropathy (SVN) and as Non-Systemic Vasculitic Neuropathy (NSVN) when restricted to the nerves. OBJECTIVE: This study aimed to compare the clinical characteristics, biopsy findings and disease outcome in patients with VPN. METHODS: Clinical records of adult patients with VPN diagnosed at our institution between June-2002 and June-2019 were retrospectively reviewed. Demographic characteristics, clinical manifestations, nerve conduction studies, nerve biopsies, treatment and clinical evolution were analyzed in all patients with at least 6 months follow-up. RESULTS: Twenty-five patients with VPN were included (SVN, n = 10; NSVN, n = 15). No significant differences in demographic or clinical features were found between groups. The median delay between symptom onset and nerve biopsy was significantly longer in NSVN patients (10 vs 5.5 months, p = 0.009). Erythrocyte sedimentation rate (ESR) values over 20 mm/h were significantly more common in SVN patients (100% vs. 60%, p = 0.024). Nerve biopsies showed active lesions more frequently in treatment-naive patients compared to those who had received at least 2 weeks of corticosteroids (92% vs 38%; p = 0.03), with a higher proportion of definite VPN cases (92 vs 46%; p = 0.04). CONCLUSIONS: Although the clinical manifestations are similar, ESR is an important tool to help distinguish between both conditions. Early nerve biopsy in untreated patients increases diagnostic accuracy, avoiding misdiagnosis. SN - 2214-3602 UR - https://www.unboundmedicine.com/medline/citation/33104037/Vasculitic_Peripheral_Neuropathy,_Differences_Between_Systemic_and_Non-Systemic_Etiologies:_A_Case_Series_and_Biopsy_Report L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JND-200576 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.