METHODS: We recruited 50 SLE patients (1 male to 12.5 females, aged 20-80 years) reporting painful disturbances. We conducted a comprehensive clinical and neurophysiological evaluation, using Nerve Conduction Studies and Quantitative Sensory Testing. Additionally, we carried out an extensive laboratory assessment of disease-related serological parameters. We also performed a thorough skin biopsy analysis, investigating somatic and autonomic innervation while detecting complement and inflammatory cell infiltrates within the skin.
RESULTS: Out of 50 patients, 19 were diagnosed with SFN, primarily characterized by a non-length-dependent distribution; 7 had a mixed neuropathy, with both large and small fiber involvement. Patients with SFN were younger than patients with a mixed neuropathy (p = .0143); furthermore, they were more likely to have a history of hypocomplementemia (p = .0058) and to be treated with cyclosporine A (p = .0053) compared to patients without neuropathy. However, there were no significant differences in painful and autonomic symptoms between patients with and without SFN.
CONCLUSIONS: This study highlights the relevant frequency of SFN with a non-length-dependent distribution among SLE patients experiencing painful symptoms. Indeed, SFN emerges as an early manifestation of SLE-related neuropathy and is closely associated with hypocomplementemia, suggesting a potential pathogenic role of the complement system. Moreover, SFN may be influenced by disease-modifying therapies. However, the precise role of SFN in shaping painful and autonomic symptoms in patients with SLE remains to be fully elucidated.
方法:我们招募了50名SLE患者(1名男性至12.5名女性,20-80岁)报告痛苦的干扰。我们进行了全面的临床和神经生理学评估,使用神经传导研究和定量感觉测试。此外,我们对疾病相关血清学参数进行了广泛的实验室评估.我们还做了彻底的皮肤活检分析,研究躯体和自主神经支配,同时检测皮肤内的补体和炎症细胞浸润。
结果:在50名患者中,19人被诊断为SFN,主要特征为非长度依赖性分布;7患有混合性神经病,涉及大纤维和小纤维。SFN患者比混合性神经病患者年轻(p=.0143);此外,与无神经病变的患者相比,他们更可能有低补体血症病史(p=.0058),并且更可能接受环孢素A治疗(p=.0053).然而,有和没有SFN的患者在疼痛和自主神经症状方面没有显著差异.
结论:本研究强调了在出现疼痛症状的SLE患者中,非长度依赖性分布的SFN的相关频率。的确,SFN是SLE相关神经病变的早期表现,与低补体血症密切相关。提示补体系统的潜在致病作用。此外,SFN可能受到疾病改善疗法的影响。然而,SFN在SLE患者疼痛和自主神经症状形成中的确切作用仍有待完全阐明.