TWO INTERESTING CASES OF VASCULITIC NEUROPATHY

WO 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.