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Peripheral neuropathy in Wegener’s granulomatosis, Churg–Strauss syndrome and microscopic polyangiitis
  1. Luigi Cattaneo1,
  2. Elisabetta Chierici1,
  3. Laura Pavone2,
  4. Chiara Grasselli2,
  5. Paolo Manganelli3,
  6. Carlo Buzio2,
  7. Giovanni Pavesi1
  1. 1
    Sezione di Neurologia, Dipartimento di Neuroscienze, Università degli Studi di Parma, Italy
  2. 2
    Dipartimento di Clinica Medica e Scienze della Prevenzione, Università degli Studi di Parma, Italy
  3. 3
    Unità Operativa di Reumatologia e Medicina Interna, Azienda Ospedaliero-Universitaria di Parma, Italy
  1. Dr Luigi Cattaneo, Sezione di Neurologia, Dipartimento di Neuroscienze, Università degli Studi di Parma, Via Gramsci 14, 43100 Parma, Italy; luigi.cattaneo{at}nemo.unipr.it

Abstract

Objective: To compare the clinical aspects of peripheral neuropathy associated with Wegener’s granulomatosis (WG), Churg–Strauss syndrome (CSS) and microscopic polyangiitis (MP).

Methods: Cohort study conducted in a single university hospital. Patients were included when a definite diagnosis of WG, CSS or MP was made according to the current classification criteria in our hospital, between 1999 and 2006. All patients underwent periodically clinical and electrophysiological screening for peripheral neuropathy, assessment of disability, and clinical and laboratory evaluation during a mean follow-up of 38 months.

Results: Sixty-four consecutive patients diagnosed with WG (26 patients), CSS (26 patients) and MP (12 patients) were recruited. Peripheral neuropathy occurred in 27/64 patients: six with WG, 15 with CSS and six with MP. Neuropathy occurred earlier in the disease history in CSS and MP compared with WG. Among patients with WG, those who developed peripheral neuropathy during follow-up were older than those without neuropathy both at the time of onset and of diagnosis of vasculitis. Distal symmetric polyneuropathy was present in 11 patients, and single or multiple mononeuropathy in 16. Patients with WG had a less severe form of mononeuritis multiplex than CSS or MPA patients. Disability and pain were greater in patients with mononeuropathy, although one-third of them were painless. Relapses of neuropathy were extremely infrequent.

Conclusions: Peripheral neuropathy in WG occurs less frequently, later in the disease course and in a milder form than in CSS and MP. Single or multiple mononeuropathy associated with these subsets of vasculitis can often be painless.

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Footnotes

  • Research funding: Luigi Cattaneo, Elisabetta Chierici and Chiara Grasselli were supported by a grant from the Italian Ministry of University and Research (MIUR)

  • Competing interests: None.

  • Abbreviations:
    AASVs
    antineutrophil cytoplasmic antibody associated systemic vasculitides
    ANCA
    antineutrophil cytoplasmic antibodies
    BVAS
    Birmingham Vasculitis Activity Score
    CSS
    Churg–Strauss syndrome
    MN
    mononeuropathy
    MP
    microscopic polyangiitis
    PNP
    polyneuropathy
    SVSVs
    small vessel systemic vasculitides
    WG
    Wegener’s granulomatosis

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