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Peripheral Neuropathy
Published in Charles Theisler, Adjuvant Medical Care, 2023
Although there are multiple causes of neuropathy, diabetes and alcohol are the two most common causes. Up to one-half of people with diabetes have peripheral neuropathy. Disorders of peripheral nerves are also the most common neurological complications of systemic amyloidosis. Nutritional disorders such as thiamine deficiency, also known as “dry” beriberi, may cause peripheral neuropathy. Vitamin B12 (cyanocobalamin) deficiency causes neurologic disease, most commonly a combination of spinal cord disease and peripheral nerve disease (myeloneuropathy). Vitamin B6 (pyridoxine) deficiency from severe malabsorption or as a consequence of therapy with isoniazid, cycloserine, hydralazine, or penicillamine can cause peripheral neuropathy.1 Vasculitic neuropathy can also damage nerves. Other factors may further contribute to nerve damage such as injury, high blood pressure, high cholesterol, some drugs, metabolic problems, and smoking.2 Despite the different etiologies leading to neuropathic pain, increased neuronal excitability is thought to be the underlying mechanism for all forms of painful neuropathies.
Vasculitis induced by drugs
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Michiel De Vries, Marjolein Drent, Jan-Wil Cohen Tervaert
Classical clinical findings include purpura, arthralgias and glomerulonephritis, and alveolar haemorrhage due to pulmonary vasculitis. Antiviral treatment with an interferon mostly leads to improvement of vasculitic symptoms in hepatitis C-associated mixed cryoglobulinaemia, but vasculitis may also exacerbate during IFN treatment. In these cases, the most common symptom is vasculitic neuropathy. However, peripheral neuropathy in an HCV-infected patient treated with IFN may also be caused by direct neurotoxic or antiangiogenic effects of IFN itself.98
Peripheral neuropathies
Published in Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen, Clinical Pain Management, 2008
Ravikiran Shenoy, Katherine Roberts, Praveen Anand
Pain is a common symptom in vasculitic neuropathy, and the extent of sensory loss and motor dysfunction depends on the nerves affected. The clinical picture is usually that of mononeuritis multiplex. If the involvement is extensive, the deficit may be more or less symmetrical, simulating a polyneuropathy. The neuropathy may occur on the background of a systemic illness or occasionally may be the presenting feature. Included in this category are polyarteritis nodosa, Churg–Strauss syndrome, rheumatoid arthritis, lupus erythematosus, systemic sclerosis, and Wegener’s granulomatosis.
Current perspectives on the diagnosis, assessment, and management of vasculitic neuropathy
Published in Expert Review of Neurotherapeutics, 2022
Yuki Fukami, Haruki Koike, Masahisa Katsuno
Vasculitides are a heterogeneous group of diseases in which the vascular walls of different organs are injured by inflammatory cells, causing secondary ischemic damage [1–4]. Those vasculitides not associated with a presumed etiology or a specific systemic disease are classified based on the size of the affected blood vessels [5]. Since there are no large blood vessels in the peripheral nervous system, the relationship between vasculitis and neuropathy has been investigated in medium to small vasculitis [4,5]. Vasculitis may also be secondary to a variety of diseases, ranging from autoimmune to infectious diseases [1,2]. Although vasculitis may be confined to the peripheral nervous system [2,6,7], most patients with vasculitic neuropathy have systemic manifestations [8]. Therefore, its diagnosis and management require multidisciplinary approaches. Neurologists as well as physicians and researchers in other fields, including internal medicine, nephrology, rheumatology, and pathology need to be aware of the neuropathic aspects of this disease. Herein, we review the characteristics of vasculitic neuropathy, focusing on the clinical, pathological, and therapeutic aspects of the disease. We searched PubMed and Google Scholar for reports published between July 2017 and July 2022. We used the search terms ‘vasculitis,’ ‘vasculitic neuropathy,’ and/or ‘treatment.’ We searched for other relevant earlier reports in the reference lists of reports identified through the database search. We cite major updated reviews to provide further reading.