TWO INTERESTING CASES OF VASCULITIC NEUROPATHY

Abstract

TWO INTERESTING CASES OF VASCULITIC
NEUROPATHY Abstract Peripheral neuropathy is an
important, and often the presenting clinical feature of the
vasculitides. We report two cases presenting as peripheral
neuropathy with connective tissue diseases. Case vignette 1A
19yr old female presented with benumbed sensation over the
right leg foot, with tripping of right toes while walking for past
3 months, with similar complaints in the left leg 1 month later.
On examination she had cushingoid features with purpuric
rash over the right palm, and wasting over lateral aspect of
right leg with distal hypotonia. She had involvement of both
the common peroneal nerves and right tibial nerve. There was
sequential involvement in the pattern of mononeuritis
multiplex. Nerve biopsy was suggestive of vasculitic
neuropathy. Skin biopsy showed fibrinoid necrosis of medium
arteries involving intradermal portion suggestive of
Polyarteritis nodosa. Case vignette 243year old female,
presented with pins and needles and benumbed sensation
involving left foot 4 months back which progressed up to the
knee in 3 weeks, associated with weakness of left foot, and
with similar complaints in the right foot a month later.
On examination she had hypotonia of left foot with weakness
of dorsiflexion more than plantar flexion of both lowerlimbs.
She also had decreased pain, touch, temperature over both
foot upto one-third of leg, left more than right. Her RA factor
and anti- CCP were positive suggestive of rheumatoid
arthritis. ConclusionThese two cases are presented to
enlighten the varying presentations of vasculitic neuropathy in
the setting of connective tissue diseases.