Ultrasonographic characteristics of peripheral neuropathy in systemic lupus erythematosus

• Published in: Clinical neurophysiology Vol. 170; pp. 41 - 48
• Main Authors: Hu, Nan, Nie, Yuxue, Dong, Xingbei, Niu, Jingwen, Cui, Liying, Liu, Mingsheng
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.02.2025
• Subjects: Adult; Female; Humans; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - diagnostic imaging; Lupus Erythematosus, Systemic - physiopathology; Male; Median Nerve - diagnostic imaging; Median Nerve - physiopathology; Middle Aged; Nerve ultrasound; Neural Conduction - physiology; Neurology; Peripheral Nervous System Diseases - diagnostic imaging; Peripheral Nervous System Diseases - etiology; Peripheral Nervous System Diseases - physiopathology; Peripheral neuropathy; Systemic lupus erythematosus; Ulnar Nerve - diagnostic imaging; Ulnar Nerve - physiopathology; Ultrasonography - methods; Young Adult; Peripheral neuropathy; Nerve ultrasound; Systemic lupus erythematosus
• ISSN: 1388-2457; 1872-8952; 1872-8952
• DOI: 10.1016/j.clinph.2024.12.002

•Nerve enlargement was common in SLE patients, in the forms of mild to moderate and focal thickening in upper limbs.•Nerve enlargement might be a potential indicator of high disease activity and poor functional status in SLE.•A combined examination using NCS and nerve ultrasound might be more effective in detecting SLE-related peripheral neuropathy. To explore the ultrasonographic characteristics of SLE-related peripheral neuropathy (PN) using nerve ultrasound. Patients with SLE were recruited consecutively between December 2022 and June 2023. Detailed clinical assessment and nerve ultrasound were conducted on each SLE patient and healthy control (HC) at predetermined sites of peripheral nerves. The upper limit of the CSA for each nerve location was defined as 95th percentile in healthy controls for the identification of nerve enlargement. Nerve conduction studies (NCS) and relevant ancillary examinations were conducted on all SLE patients for comparisons. A total of 32 SLE female patients and age- and gender-marched 52 HC were finally recruited. At M6 (P = 0.041) point of median nerve, U1 (P < 0.001) and U6-10 (P < 0.001, =0.008, <0.001, <0.001, <0.001, respectively) points of ulnar nerve, the CSA in SLE patients were remarkably higher than that in HC. Mild and moderate nerve enlargement were detected in 12 and 20 SLE patients, respectively. Only 12 tested nerves showed both axonal damage in electrophysiological studies and nerve enlargement under ultrasound. Nerve enlargement was extremely common in SLE patients, mainly in the forms of mild to moderate and focal thickening in upper limbs. There was significant inconsistency between NCS and ultrasound in detecting peripheral nerve involvement and a combined examination using NCS and nerve ultrasound might be more effective in detecting SLE-related PN.