[Peripheral neuropathies during systemic diseases: Part II (vasculitis)].

Area of Science:

• Neurology
• Rheumatology
• Immunology

Context:

• Primary systemic vasculitides, particularly those affecting small and medium vessels, frequently manifest with peripheral neuropathies.
• Neuropathy can be a presenting symptom or a complication of known vasculitic disease, necessitating careful diagnostic evaluation.

Purpose:

• To outline the diagnostic approach for neuropathy in the context of systemic vasculitis.
• To differentiate vasculitic neuropathy from other neuropathies and guide etiological diagnosis.

Summary:

• Peripheral neuropathies are common in systemic vasculitis. A neuropathy appearing in a known vasculitis patient suggests specific nerve injury, especially with systemic signs. When neuropathy is the first symptom, prompt collaboration between neurologists and internists is crucial.
• Standardized electro-clinical investigation helps diagnose the neuropathy's characteristics. Etiological diagnosis involves assessing systemic manifestations (e.g., kidney, lung, or ENT involvement), biological markers (e.g., ANCA, rheumatoid factor, cryoglobulinemia), and potentially neuromuscular biopsy for histological confirmation.

Impact:

• Facilitates accurate diagnosis and timely management of vasculitic neuropathy.
• Improves patient outcomes by enabling targeted treatment strategies for systemic vasculitis and associated nerve damage.