title: Sensory ganglionopathy with livedoid vasculopathy controlled by immunotherapy.
abstract: BACKGROUND
  Livedoid vasculopathy is a rare dermatological condition characterized by painful ulceration, atrophic scarring, and persistent livedo reticularis. The pathogenesis is unclear.
  
  
  METHODS
  We report a patient with biopsy-proven livedoid vasculopathy who developed a progressive sensory ganglionopathy with profound sensory ataxia. Serial nerve conduction assessments were undertaken.
  
  
  RESULTS
  Combined treatment with prednisolone and mycophenolate mofetil failed to control the ganglionopathy. After addition of rituximab, both symptoms and nerve conduction studies showed stabilization.
  
  
  CONCLUSIONS
  Sensory ganglionopathies associated with autoimmune and inflammatory conditions may be characterized by a sub-population of "sick" dorsal root ganglia that can be rescued with aggressive immunotherapy.
authors.affiliation: Department of Clinical Neurophysiology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield, S10 2JF.
authors.forename: James J P
authors.initials: JJ
authors.lastname: Alix
authors.forename: Marios
authors.initials: M
authors.lastname: Hadjivassiliou
authors.forename: Rokiahmah
authors.initials: R
authors.lastname: Ali
authors.forename: David
authors.initials: D
authors.lastname: Slater
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Messenger
authors.forename: D Ganesh
authors.initials: DG
authors.lastname: Rao
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000328:Adult; D001259:Ataxia / Q000150:complications / Q000628:therapy; D005260:Female; D017950:Ganglia, Sensory / Q000473:pathology*; D006225:Hand / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D054068:Livedo Reticularis / Q000150:complications* / Q000628:therapy*; D009431:Neural Conduction / Q000502:physiology; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000628:therapy*; D012867:Skin / Q000473:pathology / Q000503:physiopathology
keywords: immunosuppression; livedoid vasculopathy; nerve conduction studies; neuronopathy; sensory ganglionopathy