Nervous system dysfunction in Henoch-Schonlein syndrome: systematic review of the literature

Garzoni, Luca; Vanoni, Federica; Rizzi, Mattia; Simonetti, Giacomo D; Goeggel Simonetti, Barbara; Ramelli, Gian P; Bianchetti, Mario G (2009). Nervous system dysfunction in Henoch-Schonlein syndrome: systematic review of the literature. Rheumatology, 48(12), pp. 1524-9. Oxford: Oxford University Press 10.1093/rheumatology/kep282

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OBJECTIVE: CNS or peripheral nervous system dysfunction sometimes occurs in Henoch-Schönlein patients. METHODS: We review all Henoch-Schönlein cases published after 1969 with CNS dysfunction without severe hypertension and neuroimaging studies (n = 35), cranial or peripheral neuropathy (n = 15), both CNS and peripheral nervous system dysfunction without severe hypertension (n = 2) or nervous system dysfunction with severe hypertension (n = 2). Forty-four of the 54 patients were <20 years of age. RESULTS: In patients with CNS dysfunction without or with severe hypertension the following presentations were observed in decreasing order of frequency: altered level of consciousness, convulsions, focal neurological deficits, visual abnormalities and verbal disability. Imaging studies disclosed the following lesions: vascular lesions almost always involving two or more vessels, intracerebral haemorrhage, posterior subcortical oedema, diffuse brain oedema and thrombosis of the superior sagittal sinus. Following lesions were noted in the subjects with cranial or peripheral neuropathy without severe hypertension: peroneal neuropathy, peripheral facial palsy, Guillain-Barré syndrome, brachial plexopathy, posterior tibial nerve neuropathy, femoral neuropathy, ulnar neuropathy and mononeuritis multiplex. Persisting signs of either CNS (n = 9) or peripheral (n = 1) nervous system dysfunction were sometimes reported. CONCLUSIONS: In Henoch-Schönlein syndrome, signs of nervous system dysfunction are uncommon but clinically relevant. This review helps clinicians managing Henoch-Schönlein syndrome with nervous system dysfunction.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Simonetti, Giacomo and Bianchetti, Mario Giovanni

ISSN:

1462-0324

Publisher:

Oxford University Press

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:12

Last Modified:

28 Oct 2019 01:52

Publisher DOI:

10.1093/rheumatology/kep282

PubMed ID:

19797041

Web of Science ID:

000272081000014

BORIS DOI:

10.7892/boris.31831

URI:

https://boris.unibe.ch/id/eprint/31831 (FactScience: 196566)

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