Document Detail

Peripheral neuropathy in ANCA-associated vasculitis: outcomes from the European Vasculitis Study Group trials.
MedLine Citation:
PMID:  21890618     Owner:  NLM     Status:  Publisher    
Objectives. To describe the incidence and prevalence of peripheral neuropathy in ANCA-associated vasculitis (AAV); to evaluate the correlation of neuropathy with other clinical manifestations; and to review the long-term outcome of treated neuropathy.Methods. Presence of neuropathy was determined using items from the BVAS and vasculitis damage index (VDI) during 5 years from enrolment into clinical trials conducted by the European Vasculitis Study Group (EUVAS).Results. Forty (8%) of 506 patients had vasculitic neuropathy at baseline. Incidence of vasculitic motor-involving neuropathy was identical between microscopic polyangiitis (MPA) [16 (7%) out of 237] and granulomatosis with polyangiitis (Wegener's) [19 (7%) out of 269], P = 0.94. Pure sensory neuropathy was reported in 5 (2%) out of 269 patients with granulomatosis with polyangiitis, but not in patients with MPA, P = 0.065. Vasculitic neuropathy at baseline was associated with systemic [odds ratio (OR) = 1.81], cutaneous (OR = 1.29), mucous membranes (OR = 1.21) and ENT (OR = 1.14) manifestations of vasculitis (P < 0.05 for all). There was no association between neuropathy and renal, chest, cardiovascular or abdominal vasculitis or with overall mortality. Of the 40 patients with vasculitic neuropathy at baseline, 35% had complete resolution within 6 months. The cumulative prevalence of chronic neuropathy at any time up to 5 years was 15% (75 of 506). Chronic neuropathy was associated with older age [hazard ratio (HR) = 1.03], higher BVAS (HR = 1.07) and lower baseline creatinine (HR = 0.82) (P < 0.01 for all).Conclusion. Peripheral neuropathy is an occasional accompaniment of AAV that typically remits in concert with non-neuropathic manifestations, usually involves motor nerves, often produces long-lasting symptoms and is not associated with life-threatening organ involvement.
Ravi Suppiah; Robert D M Hadden; Rajbir Batra; Nigel K Arden; Michael P Collins; Loic Guillevin; David R W Jayne; Raashid A Luqmani;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-2
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  -     ISSN:  1462-0332     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Rheumatology Department, Nuffield Orthopaedic Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal BRU, University of Oxford, Oxford, Neurology Department, King's College Hospital, London, UK, Neurology Department, Medical College of Wisconsin, Milwaukee, WI, USA, Department of Internal Medicine, Hôpital Cochin, Université Paris Descartes, Paris, France and Renal Department, Addenbrooke's Hospital, Cambridge, UK.
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