Peripheral neuropathy in ANCA-associated vasculitis: outcomes from the European Vasculitis Study Group trials. Rheumatology (Oxford) 2011 Dec;50(12):2214-22
Date
09/06/2011Pubmed ID
21890618DOI
10.1093/rheumatology/ker266Scopus ID
2-s2.0-82355172654 (requires institutional sign-in at Scopus site) 90 CitationsAbstract
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 enrollment 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.
Author List
Suppiah R, Hadden RD, Batra R, Arden NK, Collins MP, Guillevin L, Jayne DR, Luqmani RA, European Vasculitis Study GroupAuthor
Michael P. Collins MD Professor in the Neurology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAnti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Chronic Disease
Clinical Trials as Topic
Europe
Female
Humans
Incidence
Male
Middle Aged
Peripheral Nervous System Diseases
Prevalence
Treatment Outcome
