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Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Nephrotic Syndrome III : Nursing Management01:24

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Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
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Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

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IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
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Nephrotic Syndrome I : Introduction01:24

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Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
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Peripheral Artery Disease IV: Nursing Management01:26

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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Assessment of the Cardiovascular System III: Palpation01:27

Assessment of the Cardiovascular System III: Palpation

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Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
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Related Experiment Video

Updated: Jan 10, 2026

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Severe lupus vasculitic neuropathy.

Apoorva Anil Kumar1, Victor Jia Wei Zhang2, Carine J Moezinia2

  • 1National Hospital for Neurology and Neurosurgery, London, UK apoorvaanil.kumar@nhs.net.

Practical Neurology
|November 20, 2025
PubMed
Summary

Severe axonal sensorimotor neuropathy can be an early sign of neurological lupus. Prompt diagnosis and treatment with immunosuppression, like cyclophosphamide and prednisolone, led to significant improvement in a patient with multisystem lupus vasculitis.

Keywords:
CLINICAL NEUROLOGYNEUROMUSCULARSLEVASCULITIS

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Area of Science:

  • Neurology
  • Rheumatology
  • Immunology

Background:

  • Peripheral neuropathy is an under-recognized presenting manifestation of neurological lupus.
  • Systemic lupus erythematosus (SLE) can affect the nervous system, leading to diverse neurological complications.
  • Vasculitic processes are a key consideration in patients with rapidly progressive neuropathy and systemic symptoms.

Purpose of the Study:

  • To highlight the diagnostic challenges in a case of severe axonal sensorimotor neuropathy secondary to lupus vasculitis.
  • To discuss the interpretation of autoantibody serology following intravenous immunoglobulin (IVIG) treatment.
  • To emphasize the importance of recognizing peripheral neuropathy as a potential initial presentation of neurological lupus.

Main Methods:

  • Case report of a 31-year-old woman with generalized pain and weakness.
  • Diagnostic workup including autoantibody testing (lupus and antiphospholipid antibodies).
  • Treatment initiated with cyclophosphamide and prednisolone for severe multisystem lupus vasculitis.

Main Results:

  • The patient presented with rapidly progressive axonal sensorimotor neuropathy, preceded by transient joint symptoms, rash, and hair loss.
  • Blood tests revealed strongly positive lupus and antiphospholipid antibody titres post-IVIG treatment.
  • Treatment with cyclophosphamide and prednisolone resulted in notable clinical improvement.

Conclusions:

  • Peripheral neuropathy can be a critical early indicator of neurological lupus.
  • Careful interpretation of serological results is necessary, especially after treatments like IVIG.
  • Multisystem lupus vasculitis requires timely immunosuppressive therapy for effective management and improved patient outcomes.