Peripheral Neuropathies in Patients with Systemic Lupus Erythematosus

Introduction: Peripheral neuropathy (PN) is a known but uncommon manifestation of systemic lupus erythematosus (SLE).

Patients and methods: We conducted a retrospective study over 14 years period. Patients diagnosed with SLE (revised ACR criteria for SLE diagnosis) and presenting PN at any time of the disease course are studied. Patients having another disease which could be complicated with PN are excluded.

Results: Five SLE patients have PN (2% of our 246 SLE patients). They are four women and a man. Their mean age at PN diagnosis is 29.8 years [ranges 24 and 36 years]. PN reveal SLE in three patients and occurs three years after the SLE diagnosis in two patients. Three patients have polyneuropathy and one have mononeuropathy multiplex. Acute demyelinating polyradiculoneuropathy and chronic inflammatory demyelinating polyneuropathy are noted each in one case. In all patients, PN is concomitant with other SLE manifestations supporting a disease flare. Antinuclear and anti-DNA antibodies are positive in four patients conjointly with the PN. In the other patient, they become positive two years later. All patients are treated with high dose glucocorticoids. Immunosuppressant agents are given in four patients; cyclophosphamide in three cases, and azathioprine in one case. The general outcome at the end of the treatment is favorable; two patients are free of symptoms and three others have minimal neurological sequelae.

Conclusion: PN is uncommon in SLE but can involve functional prognosis. When they are treated early, the outcome is good.

Author(s):

Ben Salem T, Belfeki N, Lamloum M, Khanfir M, Ben Ghorbel I and Houman MH

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