Diagnostic and prognostic relevance of neuromuscular biopsy in primary Sjögren's syndrome-related neuropathy
| Autor: | Robin Dhote, François Maillot, Françoise Sarrot-Reynauld, Odile Dubourg, Pierre-Yves Hatron, Xavier Mariette, Club Rhumatismes et Inflammation, Jacques-Eric Gottenberg, Benjamin Terrier, Catherine Lacroix, Elisabeth Diot, Laurence Meyer, Christelle Sordet, Loïc Guillevin |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Vasculitis Pathology medicine.medical_specialty Biopsy Immunology Gastroenterology Rheumatology Sural Nerve Adrenal Cortex Hormones Immunopathology Internal medicine Necrotizing Vasculitis medicine Immunology and Allergy Rheumatoid factor Humans Pharmacology (medical) Muscle Skeletal Aged Retrospective Studies Univariate analysis medicine.diagnostic_test business.industry Peripheral Nervous System Diseases Middle Aged medicine.disease Prognosis Peripheral neuropathy C-Reactive Protein Sjogren's Syndrome Rheumatoid arthritis Multivariate Analysis Disease Progression Female business Immunosuppressive Agents |
| Zdroj: | Arthritis and rheumatism. 57(8) |
| ISSN: | 0004-3591 |
| Popis: | Objective To evaluate the clinicobiologic presentation in patients with primary Sjogren's syndrome (SS)–related peripheral neuropathy, the histologic results of neuromuscular biopsy (NMB), and clinical outcome, and to identify prognostic factors. Methods We retrospectively studied clinical and biologic presentation of 40 patients with primary SS–related neuropathy who underwent NMB. Prognostic factors of clinical outcome were assessed by univariate and multivariate analysis. Results Patients with vasculitis (lymphocytic [n = 8] or necrotizing [n = 14]) had a higher prevalence of acute-onset neuropathy, multiple mononeuropathy, sensorimotor involvement, vascular purpura, general symptoms, increased C-reactive protein level, positivity for rheumatoid factor, hypocomplementemia, and monoclonal gammopathy compared with those without vasculitis (n = 18). Comparison between patients with necrotizing or lymphocytic vasculitis did not reveal significant differences in clinical or biologic presentation except for the presence of general symptoms and rheumatoid factor. Regarding clinical evolution, the results of NMB (P < 0.0001), in particular the presence of necrotizing vasculitis (P < 0.001), an acute neuropathy onset (P < 0.0001), general symptoms (P < 0.0001), multiple mononeuropathy (P = 0.0007), presence of sensorimotor involvement (P = 0.002), and increased C-reactive protein level (P = 0.008), were significantly associated with a better outcome in univariate analysis. In multivariate analysis, NMB resulting in the identification of patients with necrotizing vasculitis was the only variable that remained significantly associated with a better outcome (P = 0.01). Conclusion NMB is necessary to identify patients with necrotizing vasculitis, who have a better response to immunosuppressive therapy. NMB might therefore have both a diagnostic and prognostic relevance in primary SS–related neuropathy. |
| Databáze: | OpenAIRE |
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