P-ANCA vasculitic neuropathy with 12-year latency between onset of neuropathy and systemic symptoms

Steven A Greenberg, Steven A Greenberg

Abstract

Background: The differential diagnosis of chronic progressive multifocal asymmetric neuropathies is challenging. Vasculitic neuropathies, multifocal forms of chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathies, and asymmetric lower motor neuron disorders are important considerations.

Case presentation: We report a patient with an unusually long 12-year course of nonsystemic vasculitic neuropathy prior to the development of systemic manifestations.

Conclusion: We discuss some of the difficulties involved in the diagnosis of chronic progressive multifocal asymmetric neuropathies.

References

    1. Kissel JT, Slivka AP, Warmolts JR, Mendell JR. The clinical spectrum of necrotizing angiopathy of the peripheral nervous system. Ann Neurol. 1985;18:251–257.
    1. Dyck PJ, Benstead TJ, Conn DL, Stevens JC, Windebank AJ, Low PA. Nonsystemic vasculitic neuropathy. Brain. 1987;110:843–854.
    1. Franssen CF, Stegeman CA, Kallenberg CG, Gans RO, DeJong PE, Hoorntje SJ, Tervaert JW. Antiproteinase 3- and antimyeloperoxidase- associated vasculitis. Kidney Internat. 2000;57:2195–2206. doi: 10.1046/j.1523-1755.2000.00080.x.
    1. Nishino H, Rubino FA, DeRemee RA, Swanson JW, Parisi JE. Neurological involvement in Wegener's granulomatosis: An analysis of 324 consecutive patients at the Mayo Clinic. Ann Neurol. 1993;33:4–9.
    1. Puechal X, Said G. Necrotizing vasculitis of the peripheral nervous system: nonsystemic or clinically undetectable? Arthr Rheum. 1999;42:824–825. doi: 10.1002/1529-0131(199904)42:4<824::AID-ANR32>;2-0.
    1. Lewis RA, Sumner AJ, Brown MJ, Asbury AK. Multifocal demyelinating neuropathy with persistent conduction block. Neurology. 1982;32:958–964.
    1. Katz JS, Barohn RJ, Kojan S, Wolfe GI, Natoins PS, Saperstein DS, Amato AA. Axonal multifocal motor neuropathy without conduction block or other features of demyelination. Neurology. 2002;58:615–620.
    1. Chalk CH, Homburger HA, Dyck PJ. Anti-neutrophilic cytoplasmic antibodies in vasculitic peripheral neuropathy. Neurology. 1993;43:1826–1827.
    1. Pleasure D. Peripheral neuropathy as the first clinical manifestation of Wegener's granulomatosis. Arch Neurol. 2001;58:1204–1206. doi: 10.1001/archneur.58.8.1204.

Source: PubMed

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