Polyneuropathy as initial manifestation of necrotizing vasculitis and gangrene in systemic lupus erythematosus.
A patient with necrotizing vasculitis and systemic lupus erythematosus is reported. The vasculitis presented as a symmetrical sensorimotor axonal neuropathy and after three months it resulted in gangrene of a toe. Sural nerve conduction was abnormal and a biopsy of this nerve was diagnostic. Serum anti-endothelial cell antibodies were elevated during activity of the vasculitic process. Treatment with prednisone and cyclophosphamide induced a remission.
Markusse
H M
HM
Department of Rheumatology, Dr. Daniel den Hoed Clinic, Rotterdam, The Netherlands.
Vroom
T M
TM
Heurkens
A H
AH
Vecht
C J
CJ
D000328:Adult; D005260:Female; D005734:Gangrene; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000473:pathology*; D010523:Peripheral Nervous System Diseases / Q000473:pathology*; D014657:Vasculitis / Q000473:pathology*