[Neuropathies due to vasculitis in infancy].
BACKGROUND
Vasculitis are characterised by the inflammatory infiltrate, chiefly of mononuclear cells, in the walls of the blood vessels, which can lead to occlusion with necrosis and the subsequent infarction of the affected tissue.


OBJECTIVE
The Objective of this study was to determine the clinical, anatomicopathological and neurophysiological aspects of vasculitic neuropathies in infancy.


METHODS
Each patient was submitted to the following tests: a complete hemogram, systemic lupus erythematosus cells (LE cells), lupus anticoagulant, antinuclear antibodies, neutrophil anticytoplasmic antibodies, venereal disease research laboratory test (VDRL), erythrocyte sedimentation rate, liver transaminases, serological testing for hepatitis C, B and A, cytochemical study of the cerebrospinal fluid, study of motor and sensory conduction, electromyography and nuclear magnetic resonance, when required; a biopsy of the sural nerve was performed, which was replaced by a necropsy if the patient died.


RESULTS
15 patients from a total of 25 who were studied had vasculitic neuropathies; the most usual presentation was multiple mononeuropathy; aetiologies found included microscopic polyangiitis, systemic lupus erythematosus, JRA, overlap syndrome and several undetermined vasculitis. Of the patients who were submitted to a biopsy, 75% showed signs of vasculitis, which affected the small and medium sized vessels in 62.5% of patients.


CONCLUSIONS
The presence of neuropathy in association with symptoms and signs of systemic involvement suggested the possibility of a neuropathy in the course of a vasculitis. The examination of biopsy specimens of the sural nerve is useful for the diagnosis and classification of the aetiology of vasculitis. Response to treatment with immunosuppressant drugs was good, both in the case of the neuropathy and of the underlying disease.
Andrade
R
R
Hospital Universitario Arnaldo Milian Castro, Santa Clara, Villa Clara, Cuba. renea@medscape.com
Moya Machado
A
A
Gómez Conde
S
S
García Espinosa
A
A
Molina Díaz
M
M
Machado Rojas
A
A
González Rodríguez
I
I
D000293:Adolescent; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003462:Cuba / Q000453:epidemiology; D003711:Demyelinating Diseases / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D012216:Rheumatic Diseases / Q000150:complications / Q000188:drug therapy; D013497:Sural Nerve / Q000473:pathology; D014657:Vasculitis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology
D007166:Immunosuppressive Agents