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Peripheral neuropathy in antiphospholipid syndrome: a systematic review
Rafael Reis do Espírito Santos1, Cezar Augusto Muniz Caldas1, Jozélio Freire de Carvalho2
1Faculty of Medicine, Federal University of Pará, Belém-Pará.
Reumatismo
|June 4, 2025
Summary
Peripheral neuropathy is a rare complication of Antiphospholipid Syndrome (APS), predominantly affecting females. Early diagnosis and treatment, often with anticoagulation and immunosuppressants, lead to positive outcomes in most patients.
Area of Science:
- Neurology
- Rheumatology
- Immunology
Background:
- Antiphospholipid Syndrome (APS) is defined by recurrent thrombosis and antiphospholipid antibodies.
- Peripheral neurological disorders are uncommon manifestations of APS.
- Peripheral neuropathy (PN) in APS patients requires systematic review.
Purpose of the Study:
- To systematically review reported cases of peripheral neuropathy (PN) in patients with Antiphospholipid Syndrome (APS).
Main Methods:
- A systematic literature search was conducted on PubMed for articles on PN and APS published from 1966 to August 2022.
- Included articles had English abstracts.
Main Results:
- 10 articles detailing 100 APS patients with PN were identified.
- Patients were predominantly female (86-100%) and ranged from 25-78 years old.
- Mononeuritis multiplex and autonomic neuropathy were common clinical presentations; nerve biopsies were consistently positive, and most patients improved with anticoagulation, glucocorticoids, or immunosuppressants.
Conclusions:
- Peripheral neuropathy is a rare but recognized complication of Antiphospholipid Syndrome.
- PN in APS predominantly affects females and is associated with antiphospholipid antibody positivity.
- Electroneurography or nerve biopsy confirmation and prompt treatment correlate with favorable outcomes.
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