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Vasculitic neuropathy in rheumatoid disease and Sjögren syndrome

Centre de Recherche en Sciences Neurologiques, Hôpitaux Hôtel-Dieu, Sacré-Coeur, et St-Luc, Université de Montréal, Montréal, Quebec, Canada

Two patients with rheumatoid arthritis and one with Sjçgren syndrome had a severe sensorimotor neuropathy preceding or up to 5 years after the onset of the disease. Electrophysiologic and sural nerve biopsy studies revealed an axonal neuropathy. Myelinated fibers were affected to a greater extent than unmyelinated axons. Peripheral nerve damage was related to occlusion of the vasa nervorum, since vasculitic involvement of epineurial vessels was observed in all patients. Despite the severity of the neuropathy, it may recover, because, compared with axons, Schwann cells are perhaps less vulnerable to ischemia.

Address correspondence and reprint requests to Dr. Peyronnard, Centre de Recherche en Sciences Neurologiques, Département de Physiologie, Faculté de Médecine, Université de Montréal, Case postale 6208, Montréal, Québec H3C 3T8, Canada.

This study was supported in part by grants from the C.O. Monat Foundation (L.C.) and the Medical Research Council of Canada (J.M.P.).

Accepted for publication December 10, 1981.

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