Vasculitic neuropathy

Vasculitic neuropathy is a peripheral neuropathic disease due to damage to the vessels that supply blood to the nerves.

Vasculitic neuropathy can be as part of a systemic problem or can exist as a single-organ issue only affecting the peripheral nervous system (PNS).

It is diagnosed with the use of electrophysiological testing, blood tests, nerve biopsy and clinical examination.

It can cause prolonged morbidity and disability.

Treatment depends on the type but it is mostly with corticosteroids or immunomodulating therapies.

There are three main categories of vasculitic neuropathies: primary, secondary and non-systemic.

Examples of systemic vasculitic disease are: IgA vasculitis, Hypocomplementemic urticarial vasculitis, polyarteritis nodosa (PAN) and anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitides such as granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA) and microscopic polyangiitis (MPA).

Some patients with a non-vasculitic systemic disease or another illness such as infection or malignancy can subsequently develop vasculitic neuropathy as a direct consequence of the former illness; this is secondary vasculitic neuropathy.

Vasculitic neuropathy is associated with: Connective tissue diseases: rheumatoid arthritis, systemic lupus erythematosus, primary sjögren’s, dermatomyositis. Infectious diseases: hepatitis B, hepatitis C, human immunodeficiency virus (HIV), cytomegalovirus, lyme disease, human T-cell-lymphotrophic virus-I, parvovirus B19, Malignancy, Drugs (amphetamines, sympathomimetics, cocaine, Vaccinations.

Non-systemic vasculitic neuropathy (NSVN) is a diagnosis of elimination, as no systemic illness can be found, yet evidence of a vasculitic neuropathy exists.

Non-systemic vasculitic neuropathy diagnosis requires a nerve biopsy

Postsurgical inflammatory neuropathy is typically a multi-focal neuropathy which manifests thirty days after a surgical procedure.

It presents with motor and sensory symptoms, and is generally a self-limiting condition that has resolved with and without treatment.

Treatment of vasculitic neuropathy depends on its etiology.

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