Abstract
Asymptomatic electrophysiological peripheral neuropathy is described in systemic lupus erythematosus (SLE) patients. To determine if SLE could have an even earlier effect on peripheral nerve function even before the development of electrophysiological abnormalities, we compared nerve conduction studies (NCS) of SLE patients without electrophysiological or clinical peripheral neuropathy with healthy controls. Consecutive SLE patients without clinical neuropathy (or other known causes of neuropathy) underwent sensory and motor NCS of all four limbs. Results of 61 patients without electrophysiological criteria of neuropathy were compared with age- and gender-matched controls. Although still within the laboratory’s range of normal values, significant differences were found in several NCS parameters between patients and controls. SLE patients had lower amplitudes for ulnar, fibular, and tibial compound muscle action potentials (CMAP) and sural sensory nerve action potentials (SNAP); slower conduction velocities for median, ulnar, and fibular motor nerves, and median, ulnar and sural sensory nerves. SLE patients also had longer minimum F-wave latencies for median, ulnar, fibular, and tibial nerves. H reflexes were more often absent in patients. Correlations were found between the number of disease relapses and motor conduction velocities of the fibular and tibial nerves. SLE may have early effect on peripheral nerve function in patients even before they develop electrophysiological or clinical neuropathy.
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This work was supported by University of Malaya research grant (RG282/11 HTM).
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All authors contributed to the study conception, design, and material preparation. Data collection and analysis were performed by SYF and KJG. The first draft of the manuscript was written by SYF and KJG. Others revised it critically for important intellectual content. All authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript and version to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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All authors (Sue Yng FONG, Jasmin RAJA, Kum Thong WONG, and Khean Jin GOH) declare no conflict of interest.
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This study is in compliance with ethical standards. This study which involved human participants was approved by the University of Malaya Medical Centre (UMMC) Medical Ethics Committee (Ref No. 806.12). The authors certify that the study was performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Fong, SY., Raja, J., Wong, KT. et al. Systemic lupus erythematosus may have an early effect on peripheral nerve function in patients without clinical or electrophysiological neuropathy: comparison with age- and gender-matched controls. Rheumatol Int 41, 355–360 (2021). https://doi.org/10.1007/s00296-020-04610-8
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DOI: https://doi.org/10.1007/s00296-020-04610-8
Keywords
- Systemic lupus erythematosus
- Nerve conduction studies
- Early effect
- Peripheral nerve function