الفهرس 
Systemic Lupus ErythematosusOnly 14 pages are availabe for public view
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Abstract
Systemic lupus erythematosus is a chronic systemic relapsing remitting autoimmune inflammatory disease, affecting multiple organ systems including the nervous system. The reported frequency of neurological involvement varies greatly among studies, ranging from 12% to 95% of patients with SLE. Cranial and peripheral neuropathies are included in PNS syndromes of SLE as defined by the ACR Anti-ribosomal P antibody is a serological specific marker of SLE and was observed to be associated with SLE-related neuropsychiatric, renal, and hepatic disorders, but this is still controversial. The aim of this study was assessment of cranial and peripheral neuropathy in SLE and its correlation with anti-ribosomal p antibodies and disease activity. The present study was carried out on thirty patients with SLE diagnosed according to the SLICC classification criteria for SLE 2012. Twenty apparently healthy age and sex matched volunteers were included and used as control group. All patients were subjected to the following • Full medical history taking. • Thorough clinical examination. • Assessment of disease activity using SELENA-SLEDAI. • Laboratory assessment using the following: 1. Complete blood picture. 2. Serum creatinine. 3. 24 hours urinary proteins. 4. Liver function tests (ALT and AST). 5. ANA. 6. Anti-dsDNA. 7. C3 &C4. 8. Antiphospholipid antibodies (lupus anticoagulant and anticardiolipin). 9. Anti-ribosomal p antibodies for patients and controls. • Electrophysiological assessment: Systemic lupus erythematosus patients and controls were assessed by: A) Routine nerve conduction studies for assessment of peripheral nerves: Motor nerve conduction studies for median, ulnar, common peroneal, and posterior tibial nerves. Sensory nerve conduction studies for median, ulnar, radial and sural nerves. Late responses: - F wave for median, ulnar, common peroneal, and posterior tibial nerves. - Soleus H reflex. B) Electrophysiological studies for assessment of cranial nerves: Blink reflex. Visual evoked potential. Brain stem auditory evoked potential. The results of this study can be summarized as follow: • Peripheral polyneuropathy was detected in 66.67% of SLE patients. 53.33% had clinical and electrophysiological evidences of peripheral neuropathy and 13.33% had subclinical peripheral neuropathy. • SLE patients with peripheral polyneuropathy clinically characterized by having more symptoms than signs, of which sensory symptoms were predominant. • The results of electrophysiological assessment showed that sensorimotor and sensory neuropathy were detected in (36.67% and 30%) of SLE patients, respectively. Demyelinating neuropathy was the most frequent (30%), followed by axonal neuropathy (20%), then axonal and demyelinating neuropathy (16.67%). • Using combined clinical and electrophysiological assessment, no cranial neuropathy of the studied cranial nerves was detected in SLE patients. • There was significant difference between SLE patients and controls as regard frequency of anti-ribosomal p antibodies. • The sensitivity and specificity of anti- ribosomal P testing for SLE diagnosis were 20% and 100%, respectively. Positivity of anti-ribosomal p antibodies was not correlated with the presence of peripheral polyneuropathy. • Peripheral polyneuropathy was significantly negatively correlated with C3 and C4 level of SLE patients and significantly positively correlated with disease activity.