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一组自身免疫性疾病患者中免疫介导性神经病的患病率及特征

Prevalence and characteristics of immunomediated neuropathies in a group of patients with autoimmune diseases.

作者信息

Servioli Luisa, Pérez Cristina, Consani Sandra, Suárez Alejo, Sehabiaga Gabriel, Collazo Cecilia, Catalá Gaspar

机构信息

Autoimmune Diseases Unit, Department of Internal Medicine, Medical Clinic "1", Montevideo, Uruguay.

出版信息

J Clin Neuromuscul Dis. 2007 Dec;9(2):285-90. doi: 10.1097/CND.0b013e318157614b.

Abstract

OBJECTIVE

To determine the prevalence and the clinical-neurophysiological characteristics of immunomediated peripheral neuropathies (PN) in a group of patients with systemic autoimmune diseases.

METHOD

Fifty-nine patients with proved systemic autoimmune diseases were included. Patients underwent clinical examination and nerve conduction studies to diagnose the PN.

RESULTS

Immune PNs were detected in 18 patients (30.5%). Out of the total number of PNs (18), 39% were sensory-motor polyneuropathies, 33% mononeuritis multiplex, 11% pure sensory polyneuropathies, 11% cranial neuropathies, and 6% proximal motor neuropathies, such as the Guillain-Barré syndrome. Nine PNs (50%) appeared at the onset of the connective tissue disorders, and the rest of the cases appeared during the course of the disease. Of the total of PNs detected in this study, only 45% had a previous diagnosis. Vasculitis was the disease that presented more associated PNs. Systemic lupus erythematosus showed the widest range of PN clinical varieties.

CONCLUSIONS

The first national prevalence rate of PNs in patients with systemic autoimmune diseases was provided: 30.5%. No comparative data were found in the international bibliography. Sensory-motor polyneuropathy was the most frequently observed form of PN, followed by mononeuritis multiplex. The NPs appeared with the same frequency both at the onset and during the course of the diseases under study; these predominated at the onset of vasculitis and primary Sjögren syndrome. The compromise of the peripheral nervous system is underdiagnosed.

摘要

目的

确定一组系统性自身免疫性疾病患者中免疫介导的周围神经病(PN)的患病率及临床神经生理学特征。

方法

纳入59例确诊为系统性自身免疫性疾病的患者。患者接受临床检查及神经传导研究以诊断PN。

结果

18例患者(30.5%)检测到免疫性PN。在所有PN病例(18例)中,39%为感觉运动性多发性神经病,33%为多发性单神经炎,11%为纯感觉性多发性神经病,11%为颅神经病,6%为近端运动神经病,如吉兰-巴雷综合征。9例PN(50%)出现在结缔组织疾病发病时,其余病例在疾病过程中出现。本研究中检测到的所有PN病例中,仅有45%曾有过诊断。血管炎是伴发PN最多的疾病。系统性红斑狼疮表现出最广泛的PN临床类型。

结论

提供了系统性自身免疫性疾病患者中PN的首个全国患病率:30.5%。国际文献中未找到可比数据。感觉运动性多发性神经病是最常见的PN形式,其次是多发性单神经炎。PN在本研究的疾病发病时和病程中出现的频率相同;在血管炎和原发性干燥综合征发病时更为常见。周围神经系统受累的诊断不足。

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