Autonomic neuropathy in systemic lupus erythematosus: cardiovascular autonomic function assessment

To assess the prevalence and the nature of autonomic neuropathy (AN) in 17 patients with inactive or mild active systemic lupus erythematosus (SLE).

Patients were tested using questionnaires related to possible AN symptoms, and four non invasive cardiovascular autonomic function tests at rest, during lying to standing, and sustained handgrip. Eleven age matched normal subjects were also enrolled as a control group.

At least one abnormal cardiovascular autonomic function test was observed in 15 of the 17 patients. The two groups did not differ in deep-breathing (parasympathetic, PS) and handgrip tests (sympathetic, S) although responses in patients with SLE tended towards abnormal values. Statistical differences were found in standing-heart rate ratio (R-R ratio) (PS) with a lower ratio in the group with SLE (p < 0.01) and in standing blood pressure with a higher decrease in systolic blood pressure (p < 0.05) in patients with SLE. No correlation was found between AN, age, disease duration and presence of Raynaud's phenomenon.

In inactive or mild active SLE, AN could represent residual abnormalities of autonomic nervous system involvement and/or could be related to glucocorticoids.