Small-diameter nerve fiber neuropathy in systemic lupus erythematosus.
BACKGROUND
Systemic lupus erythematosus (SLE) is an inflammatory, autoimmune, multiorgan disease often involving the central and peripheral nervous systems.


OBJECTIVE
To determine whether there is a selective small-diameter nerve fiber neuropathy in patients with SLE.


METHODS
Cross-sectional study.


METHODS
Stavanger University Hospital, Stavanger, Norway. Patients Sixty patients with SLE, aged 43.2 +/- 13.5 years (mean +/- SD).


METHODS
Skin biopsies, nerve conduction studies, and clinical neurologic examinations.


METHODS
Density of intraepidermal small-diameter nerve fibers in skin biopsy specimens and large-diameter nerve fiber function as determined by nerve conduction studies and clinical examinations.


RESULTS
The mean density of intraepidermal small-diameter nerve fibers in patients with SLE was 7.5 +/- 3.8/mm. Eight patients (13%) had densities below reference values, consistent with small-diameter nerve fiber neuropathy, and results of nerve conduction studies were normal in 6 of them. Eleven patients (18%) had abnormal results of nerve conduction studies, reflecting large-diameter nerve fiber neuropathy, and 4 patients (7%) were classified by an experienced neurologist as having polyneuropathy after the clinical examination.


CONCLUSIONS
An abnormal reduction in intraepidermal small-diameter nerve fiber densities is evident in some patients despite normal function of their larger nerve fibers. This adds further support to the theory that a pure small-diameter nerve fiber neuropathy may occur in SLE.
Department of Internal Medicine, Stavanger University Hospital, Norway. gola@sir.no
Lasse G
LG
Gøransson
Anne B
AB
Tjensvoll
Anita
A
Herigstad
Svein I
SI
Mellgren
Roald
R
Omdal
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology* / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000473:pathology*; D012189:Retrospective Studies; D012867:Skin / Q000294:innervation / Q000473:pathology