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Peripheral neuropathy in pediatric systemic lupus erythematosus
Liora Harel1, Masha Mukamel, Riva Brik
1Department of Pediatrics C, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Petah Tiqva, Israel.
Pediatric Neurology
|August 6, 2002
Summary
Peripheral neuropathy is an uncommon but serious complication in pediatric patients with systemic lupus erythematosus. Early recognition and management are crucial for improving outcomes in these patients.
Area of Science:
- Neurology
- Rheumatology
- Pediatrics
Background:
- Peripheral neuropathy is an uncommon manifestation of systemic lupus erythematosus (SLE).
- Its characteristics in pediatric patients are not well-defined.
- This study focuses on the clinical and electrophysiologic features of peripheral neuropathy in a pediatric SLE cohort.
Purpose of the Study:
- To characterize the clinical and electrophysiologic features of peripheral neuropathy in children and adolescents with SLE.
- To explore the relationship between neuropathy onset, SLE activity, and antiphospholipid antibodies.
- To evaluate treatment responses in this patient group.
Main Methods:
- Case series reporting on four pediatric patients (one child, three adolescents) with SLE and peripheral neuropathy.
- Clinical evaluation including neurological examination.
- Electrophysiologic studies (nerve conduction studies).
- Assessment of SLE activity and antiphospholipid antibody status (IgM and IgG anticardiolipin antibodies).
Main Results:
- Peripheral neuropathy occurred a mean of 3 years after SLE onset and correlated with SLE activity.
- Presentations included severe pain and dropfoot.
- Nerve conduction studies showed sensory and motor polyneuropathy in all, and mononeuritis multiplex in two.
- Antiphospholipid antibodies were present in all patients.
- Treatment response to steroids and immunosuppressants was variable, with two patients recovering and two showing partial response.
Conclusions:
- Peripheral neuropathy is an unusual but important neurologic manifestation in pediatric SLE.
- It can occur independently of central nervous system involvement.
- Antiphospholipid antibodies may play a role in its pathogenesis.
- Management requires a multidisciplinary approach with variable treatment responses.