NEUROPATHY AND S.L.E. (REVIEW OF THE LITERATURE AND PERSONAL RESULTS)

In 1950, for the first time, some authors described neuropathy in patients affected by SLE. This manifestation rarely was described like a beginning symptom, its incidence increased during the last ten years (from 1% to 10%). Pathogenesis is usually linked up to the evidence of vasculitic lesions due to the presence of self-antibodies which precipitation produce vasa nervorum occlusion or promote relasing of inflammatory factors. Neuropathy has until now four well-known main manifestations: –Sensory-Motory Polineuropathy: the most frequent assonal, symmetric, distal, and subacute neuropathy. –Radicular Neuropathy: with acute beginning, axonal and demielinating damage with a pathogenesis linked up to the presence of Antifosfolipidi antibodies. –Mononeuropathy Multiplex: it can be a SLE beginning symptom, assonal, also with the involvement of cranial nerves. –Autonomic Neuropathy: it can be isolated or it can be only one manifestation of a wide nervous system involvement. Between Sept. 1998 and Dec. 1999, we studied 30 patients affected by SLE; 5 patients presented a polineuropathy prevalently sensitive, assonal, distal, involving frequently inferior limbs, which represents 16.6% of the population. Even if we think necessary an enlargment of the casistic, we consider appropriate to point to the increase of neuropathy incidence in SLE patients, probably due to a neurological approach. Immunological study of these patients usually doesn't allow a correct evaluation of the peripheral nervous system involvment. Therefore, peripheric and central nervous system complications of SLE must be considered important for the course of the systemic disease and for therapeutic choice.