3 Cases of Mononeuropathy Multiplex Associated with Systematic Vasculitis

ABSTRACT

Peripheral nervous system involvement is common in systemic vasculitis, occurring most frequently in the polyarteritis nodosa (PAN) group of disorders and in rheumatoid vasculitis. Within the polyarteritis nodosa group of systemic necrotizing vasculitides, three subgroups have been described classic polyarteritis nodosa, Churg-Strauss syndrome, and an overlap syndrome. Three patients with evidence of systemic vasculitis and peripheral neuropathy were clinically and electrophysiologically investigated. All cases presented clinically with mononeuropathy multiples considered typical pattern of ischemic involvement of the peripheral nerve. The causes included polyarteritis nodosa, its Churg-strauss variant, and the overlap syndrome. Pain and weakness were frequent symptoms. Nerve conduction studies were abnormal In all cases. Necrotizing vasculitis was present as pathologic findings in two cases. All patients were treated with prednisolone alone or in combination with other immunosuppressive agents or with plasmapheresis.