title: Peripheral neuropathy in ANCA-associated vasculitis: outcomes from the European Vasculitis Study Group trials.
abstract: OBJECTIVE
  To describe the incidence and prevalence of peripheral neuropathy in ANCA-associated vasculitis (AAV); to evaluate the correlation of neuropathy with other clinical manifestations; and to review the long-term outcome of treated neuropathy.
  
  
  METHODS
  Presence of neuropathy was determined using items from the BVAS and vasculitis damage index (VDI) during 5 years from enrollment into clinical trials conducted by the European Vasculitis Study Group (EUVAS).
  
  
  RESULTS
  Forty (8%) of 506 patients had vasculitic neuropathy at baseline. Incidence of vasculitic motor-involving neuropathy was identical between microscopic polyangiitis (MPA) [16 (7%) out of 237] and granulomatosis with polyangiitis (Wegener's) [19 (7%) out of 269], P = 0.94. Pure sensory neuropathy was reported in 5 (2%) out of 269 patients with granulomatosis with polyangiitis, but not in patients with MPA, P = 0.065. Vasculitic neuropathy at baseline was associated with systemic [odds ratio (OR) = 1.81], cutaneous (OR = 1.29), mucous membranes (OR = 1.21) and ENT (OR = 1.14) manifestations of vasculitis (P < 0.05 for all). There was no association between neuropathy and renal, chest, cardiovascular or abdominal vasculitis or with overall mortality. Of the 40 patients with vasculitic neuropathy at baseline, 35% had complete resolution within 6 months. The cumulative prevalence of chronic neuropathy at any time up to 5 years was 15% (75 of 506). Chronic neuropathy was associated with older age [hazard ratio (HR) = 1.03], higher BVAS (HR = 1.07) and lower baseline creatinine (HR = 0.82) (P < 0.01 for all).
  
  
  CONCLUSIONS
  Peripheral neuropathy is an occasional accompaniment of AAV that typically remits in concert with non-neuropathic manifestations, usually involves motor nerves, often produces long-lasting symptoms and is not associated with life-threatening organ involvement.
authors: Rheumatology Department, Greenlane Clinical Centre, Epsom, Auckland, New Zealand. ravi.suppiah@gmail.com
authors: Ravi
authors: R
authors: Suppiah
authors: Robert D M
authors: RD
authors: Hadden
authors: Rajbir
authors: R
authors: Batra
authors: Nigel K
authors: NK
authors: Arden
authors: Michael P
authors: MP
authors: Collins
authors: Loic
authors: L
authors: Guillevin
authors: David R W
authors: DR
authors: Jayne
authors: Raashid A
authors: RA
authors: Luqmani
mesh_terms: D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D016896:Treatment Outcome