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NONSYSTEMIC VASCULITIC NEUROPATHY
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1987
Year
VasculitisNeurological DisorderNeuropathic PainCommon Neurological DisordersPeripheral NervesNeuromasOrthopaedic SurgeryNeurovascular DiseaseGlomerulonephritisClinical InjuryIga GlomerulonephritisNeurologyNeuropathologyNeuroimmunologyHealth SciencesRheumatologyDistal PolyneuropathySensory PolyneuropathyConstitutional SymptomsCommon DiseasesNeurological AssessmentNonsystemic Vasculitic NeuropathyPeripheral Vascular DiseaseMedicine
Nonsystemic vasculitic neuropathy affects only nerves, presenting as an ischemic neuropathy from small arteriolar necrotizing vasculitis, and prednisone has been considered to prevent new lesions. The study examined 65 necrotizing vasculitis patients, of whom 20 had nonsystemic neuropathy with a median symptom duration of 11.5 years and varied clinical patterns, and compared their outcomes to 41 systemic patients. At follow‑up, 8 of the nonsystemic patients worsened, 5 improved, 4 remained stable, and 3 died from unrelated causes.
Among 65 patients with necrotizing vasculitis, 45 had systemic and 20 had nonsystemic vascuhtic neuropathy. In nonsystemic vasculitic neuropathy, clinically only nerves are affected; there are no, or few, constitutional symptoms or serological abnormalities. The clinical and pathological features are those of an ischaemic neuropathy caused by a necrotizing vasculitis of small arterioles. These 20 patients had neuropathic symptoms for a median time of 11.5 yrs (range 1–35 yrs). The clinical pattern of neuropathy was that of multiple mononeuropathy in 13, asymmetric neuropathy in 4, distal polyneuropathy in 3, and sensory polyneuropathy in 1. As compared with their initial evaluation, 8 are now worse, 5 are better, 4 are approximately the same, and 3 are dead from unrelated causes. Prednisone was thought to prevent the development of new lesions in some cases. By contrast, of the 41 patients with systemic necrotizing vasculitis whose outcome is known, 12 are dead (median time, 1.5 yrs, range 3 months-8yrs) and 29 are alive (median time, 6 yrs, range 6 months-22 yrs).