Rheumatology International

, Volume 26, Issue 9, pp 837–840 | Cite as

Autonomic dysfunction in systemic lupus erythematosus

  • Shalimar
  • Rohini Handa
  • Kishore Kumar Deepak
  • Manvir Bhatia
  • Praveen Aggarwal
  • Ravindra Mohan Pandey
Original Article


The objectives were to study the frequency and pattern of autonomic dysfunction in systemic lupus erythematosus (SLE). Fifty-one patients of SLE and 30 age- and sex-matched healthy controls were studied prospectively using a standard battery of noninvasive tests. Autonomic symptoms were seen in 37% patients. On laboratory testing incipient dysfunction was seen in 9 (18%) cases and 1 (3%) control, while atypical involvement was seen in 11 (21%) cases and 6 (20%) controls. Autonomic dysfunction did not correlate with disease duration, lupus activity, disease damage, any particular organ involvement or the presence/absence of peripheral neuropathy. Autonomic neuropathy is not uncommon in lupus and may exist independent of peripheral neuropathy. There are no specific clinical predictors. The clinical significance of autonomic dysfunction detected by laboratory testing warrants longitudinal studies.


Systemic lupus erythematosus Autonomic Neuropathy 


  1. 1.
    West SG (1994) Neuropsychiatric lupus. Rheum Dis Clin North Am 20:129–158PubMedGoogle Scholar
  2. 2.
    Omdal R, Henriksen O, Mellgren SF, Husby G (1991) Peripheral neuropathy in systemic lupus erythematosus. Neurology 41:808–811PubMedGoogle Scholar
  3. 3.
    Straub RH, Zeuner M, Lock G, Rath H, Hein U, Scholmerich J, Lang B (1996) Autonomic and sensorimotor neuropathy in patients with systemic lupus erythematosus and systemic sclerosis. J Rheumatol 23:87–92PubMedGoogle Scholar
  4. 4.
    Magaro M, Mirone L, Altomonle L, Zoli A, Angelosanle S (1992) Lack of correlation between anticardiolipin antibodies and peripheral autonomic nerve involvement in systemic lupus erythematosus. Clin Rheumatol 11:231–234CrossRefPubMedGoogle Scholar
  5. 5.
    Allomonte L, Mirone L, Zoli A, Magaro M (1997) Autonomic nerve dysfunction in systemic lupus erythematosus: evidence for a mild involvement. Lupus 6:441–444PubMedCrossRefGoogle Scholar
  6. 6.
    Omdal R, Jorde R, Mellgren SI, Hybby G (1994) Autonomic function in systemic lupus erythematosus. Lupus 3:413–417PubMedCrossRefGoogle Scholar
  7. 7.
    Liote F, Osterland CK (1994) Autonomic neuropathy in systemic lupus erythematosus: cardiovascular autonomic function assessment. Ann Rheum Dis 53:671–674PubMedCrossRefGoogle Scholar
  8. 8.
    Hogarth MB, Judd L, Mathias CJ, Ritchie J, Stephens D, Rees RG (2002) Cardiovascular autonomic function in systemic lupus erythematosus. Lupus 11:308–312CrossRefPubMedGoogle Scholar
  9. 9.
    Gamez-Nava JI, Gonzalez-Lopez L, Ramos-Remus C, Fonseca-Gomez MM, Cardona-Munoz EG, Suarez Almazor ME (1998) Autonomic dysfunction in patients with systemic lupus erythematosus. J Rheumatol 25:1092–1096PubMedGoogle Scholar
  10. 10.
    Hochberg MC (1997) Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725PubMedCrossRefGoogle Scholar
  11. 11.
    Dyck PJ, Thomas PK (1993) Peripheral neuropathy. WB Saunders, PhiladelphiaGoogle Scholar
  12. 12.
    Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Derivation of the SLEDAI: a disease activity index for lupus patients. The committee on prognosis studies in SLE. Arthritis Rheum 35:630–640PubMedCrossRefGoogle Scholar
  13. 13.
    Gladman DD, Urowitz MB, Goldsmith CH, Fortin P, Ginzler E, Gordon C, Hanly JG, Isenberg DA, Kalunian K, Nived O, Petri M, Sanchez-Guerrero J, Snaith M, Sturfelt G (1996) The reliability of the systemic lupus international collaborating clinics/American college of rheumatology damage index in patients with systemic lupus erythematosus. Arthritis Rheum 39:363–369PubMedCrossRefGoogle Scholar
  14. 14.
    Ewing DJ, Clarke BF (1986) Autonomic neuropathy: its diagnosis and prognosis. Clin Endocrinol Metab 15:855–888PubMedCrossRefGoogle Scholar
  15. 15.
    Baun WB, Jackson A, Patton RW, Raven PB (1981) Comparison of heart rate measurement protocols used during autonomic function tests. J Appl Physiol 51:516–519PubMedGoogle Scholar
  16. 16.
    Omdal R, Loseth S, Torbergsen T, Koldingsnes W, Husby G, Mellgren SL (2001) Peripheral neuropathy in systemic lupus erythematosus—a longitudinal study. Acta Neurol Scand 103:386–391CrossRefPubMedGoogle Scholar
  17. 17.
    Hosking DJ, Bennett T, Hampton JR (1978) Diabetic autonomic neuropathy. Diabetes 27:1043–1055PubMedGoogle Scholar
  18. 18.
    Edmonds ME, Jones TC, Saunders WA, Sturrock RD (1979) Autonomic neuropathy in rheumatoid arthritis. Br Med J 2(6183):173–175PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Shalimar
    • 1
  • Rohini Handa
    • 1
  • Kishore Kumar Deepak
    • 2
  • Manvir Bhatia
    • 3
  • Praveen Aggarwal
    • 1
  • Ravindra Mohan Pandey
    • 4
  1. 1.Department of MedicineAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of PhysiologyAll India Institute of Medical SciencesNew DelhiIndia
  3. 3.Department of NeurologyAll India Institute of Medical SciencesNew DelhiIndia
  4. 4.Department of Bio-statisticsAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations