Department of Neurology, Cork University Hospital, Cork, Ireland.
Department of Neurology, Cork University Hospital, Cork, Ireland.
Neuromuscul Disord. 2020 Aug;30(8):701-706. doi: 10.1016/j.nmd.2020.07.002. Epub 2020 Jul 9.
Sensory ganglionopathies (or neuronopathies) are a rare subgroup of neuropathies characterized by involvement of sensory neurons in the dorsal root ganglion. Although much less common than central nervous system involvement, patients with systemic lupus erythematous (SLE) can develop peripheral nervous system involvement (PNS) and most commonly a chronic length dependent symmetric sensorimotor axonal polyneuropathy as a late complication of the disease. Unlike in Sjogren's syndrome, SLE-associated sensory ganglionopathy is extremely rare and usually manifests in a chronic insidious fashion. We report a 24-year-old man with SLE-associated sensory ganglionopathy manifesting an unusually acute and severe disabling clinical course with a good response to immunosuppressive therapies. Timely recognition of this rare association and early targeted immunosuppression prevented severe neurological sequelae and preserved patient's ambulation. We demonstrate videos on the evolution of patient's neurological impairment and response to treatment, contributing to the current knowledge of the natural history of PNS involvement in SLE.
感觉神经元病变(或神经元病变)是一种罕见的神经病变亚组,其特征是背根神经节中的感觉神经元受累。尽管比中枢神经系统受累少见,但患有红斑狼疮(SLE)的患者可能会出现周围神经系统受累(PNS),并且最常见的是作为疾病的晚期并发症出现慢性、长度依赖性对称感觉运动轴索性多发性神经病。与干燥综合征不同,SLE 相关的感觉神经元病变极为罕见,通常表现为慢性隐匿性方式。我们报告了一例 24 岁男性,患有 SLE 相关的感觉神经元病变,表现为异常急性和严重致残的临床病程,对免疫抑制治疗反应良好。及时认识到这种罕见的关联并早期进行有针对性的免疫抑制治疗可防止严重的神经后遗症并维持患者的步行能力。我们展示了患者神经功能障碍和治疗反应的演变视频,为 SLE 中 PNS 受累的自然史提供了当前的认识。