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Arch Neurol. 2006 Mar;63(3):401-4.

Small-diameter nerve fiber neuropathy in systemic lupus erythematosus.

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  • 1Department of Internal Medicine, Stavanger University Hospital, Norway. gola@sir.no

Abstract

BACKGROUND:

Systemic lupus erythematosus (SLE) is an inflammatory, autoimmune, multiorgan disease often involving the central and peripheral nervous systems.

OBJECTIVE:

To determine whether there is a selective small-diameter nerve fiber neuropathy in patients with SLE.

DESIGN:

Cross-sectional study.

SETTING:

Stavanger University Hospital, Stavanger, Norway. Patients Sixty patients with SLE, aged 43.2 +/- 13.5 years (mean +/- SD).

INTERVENTIONS:

Skin biopsies, nerve conduction studies, and clinical neurologic examinations.

MAIN OUTCOME MEASURES:

Density of intraepidermal small-diameter nerve fibers in skin biopsy specimens and large-diameter nerve fiber function as determined by nerve conduction studies and clinical examinations.

RESULTS:

The mean density of intraepidermal small-diameter nerve fibers in patients with SLE was 7.5 +/- 3.8/mm. Eight patients (13%) had densities below reference values, consistent with small-diameter nerve fiber neuropathy, and results of nerve conduction studies were normal in 6 of them. Eleven patients (18%) had abnormal results of nerve conduction studies, reflecting large-diameter nerve fiber neuropathy, and 4 patients (7%) were classified by an experienced neurologist as having polyneuropathy after the clinical examination.

CONCLUSIONS:

An abnormal reduction in intraepidermal small-diameter nerve fiber densities is evident in some patients despite normal function of their larger nerve fibers. This adds further support to the theory that a pure small-diameter nerve fiber neuropathy may occur in SLE.

PMID:
16533967
[PubMed - indexed for MEDLINE]
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