Jasmin R, Sockalingam S, Ramanaidu L P, Goh K J
Division of Rheumatology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Division of Rheumatology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Lupus. 2015 Mar;24(3):248-55. doi: 10.1177/0961203314552115. Epub 2014 Sep 24.
Peripheral neuropathy in systemic lupus erythematosus (SLE) is heterogeneous and its commonest pattern is symmetrical polyneuropathy. The aim of this study was to describe the prevalence, clinical and electrophysiological features, disease associations and effects on function and quality of life of polyneuropathy in SLE patients, defined using combined clinical and electrophysiological diagnostic criteria.
Consecutive SLE patients seen at the University of Malaya Medical Centre were included. Patients with medication and other disorders known to cause neuropathy were excluded. Demographic, clinical and laboratory data were obtained using a pre-defined questionnaire. Function and health-related quality of life was assessed using the modified Rankin scale and the SF-36 scores. Nerve conduction studies (NCS) were carried out in both upper and lower limbs. Polyneuropathy was defined as the presence of bilateral clinical symptoms and/or signs and bilateral abnormal NCS parameters.
Of 150 patients, 23 (15.3%) had polyneuropathy. SLE-related polyneuropathy was mainly characterized by sensory symptoms of numbness/tingling and pain with mild signs of absent ankle reflexes and reduced pain sensation. Function was minimally affected and there were no differences in quality of life scores. NCS abnormalities suggested mild length-dependent axonal neuropathy, primarily in the distal lower limbs. Compared to those without polyneuropathy, SLE-related polyneuropathy patients were significantly older but had no other significant demographic or disease associations.
SLE-related polyneuropathy is a chronic, axonal and predominantly sensory neuropathy, associated with older age. Its underlying pathogenetic mechanisms are unknown, although a possibility could be an increased susceptibility of peripheral nerves in SLE patients to effects of aging.
系统性红斑狼疮（SLE）中的周围神经病变具有异质性，其最常见的类型是对称性多神经病变。本研究的目的是描述SLE患者多神经病变的患病率、临床和电生理特征、疾病关联以及对功能和生活质量的影响，采用临床和电生理联合诊断标准进行定义。
纳入在马来亚大学医学中心就诊的连续SLE患者。排除已知由药物和其他疾病导致神经病变的患者。使用预先定义的问卷获取人口统计学、临床和实验室数据。使用改良Rankin量表和SF - 36评分评估功能和与健康相关的生活质量。对上下肢均进行神经传导研究（NCS）。多神经病变定义为存在双侧临床症状和/或体征以及双侧异常NCS参数。
150例患者中，23例（15.3%）有多神经病变。SLE相关多神经病变主要表现为麻木/刺痛和疼痛等感觉症状，伴有轻度体征，如踝反射消失和痛觉减退。功能受影响最小，生活质量评分无差异。NCS异常提示轻度长度依赖性轴索性神经病变，主要累及下肢远端。与无多神经病变的患者相比，SLE相关多神经病变患者年龄显著更大，但在其他人口统计学或疾病关联方面无显著差异。
SLE相关多神经病变是一种慢性、轴索性且主要为感觉性的神经病变，与年龄较大有关。其潜在的发病机制尚不清楚，尽管一种可能性是SLE患者的周围神经对衰老影响的易感性增加。
