Harel Liora, Mukamel Masha, Brik Riva, Blau Hannah, Straussberg Rachel
Department of Pediatrics C, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Petah Tiqva, Israel.
Pediatr Neurol. 2002 Jul;27(1):53-6. doi: 10.1016/s0887-8994(02)00377-6.
Peripheral neuropathy is an uncommon manifestation of systemic lupus erythematosus and has not yet been characterized in pediatric patients. We report the clinical and electrophysiologic features of peripheral neuropathy in one child and three adolescents with lupus erythematosus. There were three females and one male. The peripheral neuropathy followed the onset of lupus erythematosus by a mean of 3 years. The onset of the neuropathy correlated with lupus erythematosus activity and presented with either severe pain or dropfoot. Nerve conduction studies revealed sensory and motor polyneuropathy in all patients and mononeuritis multiplex in two patients. Only one patient had associated central nervous system involvement at that time. All patients were positive for IgM and IgG anticardiolipin antibodies. Patients were treated with steroids, gabapentin, carbamazepine, azathioprine, and cyclophosphamide. Response to treatment was variable: two patients recovered and two had a partial response. Although an unusual manifestation, peripheral neuropathy should be kept in mind as part of the neurologic spectrum in lupus erythematosus. It is not necessarily associated with central nervous system disease. A role for antiphospholipid antibodies in the pathogenesis is suggested.
周围神经病变是系统性红斑狼疮的一种罕见表现，在儿科患者中尚未有特征描述。我们报告了一名儿童和三名青少年红斑狼疮患者周围神经病变的临床和电生理特征。其中有三名女性和一名男性。周围神经病变在红斑狼疮发病后平均3年出现。神经病变的发作与红斑狼疮活动相关，表现为严重疼痛或足下垂。神经传导研究显示所有患者均有感觉和运动性多发性神经病，两名患者有多发性单神经炎。当时只有一名患者伴有中枢神经系统受累。所有患者的IgM和IgG抗心磷脂抗体均为阳性。患者接受了类固醇、加巴喷丁、卡马西平、硫唑嘌呤和环磷酰胺治疗。治疗反应各不相同：两名患者康复，两名患者部分缓解。尽管周围神经病变是一种不寻常的表现，但在红斑狼疮的神经系统谱系中应将其视为一部分。它不一定与中枢神经系统疾病相关。提示抗磷脂抗体在发病机制中起作用。
