Small fiber neuropathy and related factors in patients with systemic lupus erythematosus; the results of cutaneous silent period and skin biopsy

Adv Rheumatol. 2020 Jun 5;60(1):31. doi: 10.1186/s42358-020-00133-9.

Abstract

Introduction: Evaluating small nerve fibers in patients with systemic lupus erythematosus (SLE) using cutaneous silent period (CSP) and skin biopsy and assesssing the relationship between clinical signs, autoantibodies and neuropathic pain score.

Objective - methods: Fifty one SLE patients and 46 healthy volunteers were included in this study. Nerve conduction studies and CSP were performed both on upper and lower limbs in subjects. Skin biopsy was performed and the number of epidermal nerve density and IL-6 staining were evaluated.

Results: In SLE patients, CSP latencies were significantly prolonged both in lower and upper limbs and lower and upper extremity CSP durations were significantly shorter when compared to controls (p < 0.001). The number of epidermal nerve was significantly lower in SLE patients when compared to healthy controls (p < 0.001).

Conclusion: We detected marked small nerve fiber damage in both lower and upper limbs in SLE patients using CSP. Decreased epidermal nerve density also supports this finding.

Keywords: Cutaneous silent period; Electromyography; Epidermal nerve density; Small fiber neuropathy; Systemic lupus erythematosus.

MeSH terms

  • Adult
  • Biopsy
  • Case-Control Studies
  • Female
  • Humans
  • Lower Extremity / innervation
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / physiopathology*
  • Lupus Nephritis / pathology
  • Lupus Nephritis / physiopathology
  • Male
  • Nerve Fibers / pathology
  • Nerve Fibers / physiology*
  • Neural Conduction / physiology*
  • Neuralgia / diagnosis
  • Neuralgia / physiopathology
  • Pain Threshold / physiology
  • Skin / innervation
  • Skin / pathology
  • Small Fiber Neuropathy / etiology
  • Small Fiber Neuropathy / pathology
  • Small Fiber Neuropathy / physiopathology*
  • Upper Extremity / innervation