Prevalence Of Peripheral Neuropathy And Its Electrophysiological Types In Systemic Lupus Erythematosus Patients At Kenyatta National Hospital

Abstract

Background: Peripheral neuropathy which is one of the neuropsychiatric syndromes of SLE, develops in 2% to 36% of patients. Poor quality of life scores and high disease activity indices have been associated with it. Benefits of early identification and treatment on the progression and severity of neuropathy have been demonstrated in studies. There is inadequate data on neurological manifestations of SLE in Africa. Objective: To determine the prevalence of peripheral neuropathy and its electrophysiological types and to determine and correlate quality of life with presence of peripheral neuropathy among patients with SLE attending the rheumatology clinic at Kenyatta National hospital (KNH). Methodology: A Cross-sectional Study was carried out at Kenyatta National Hospital, Rheumatology outpatient clinic.The study consecutively selected Fourty eight patients who were 18 years and above with a diagnosis of SLE as per the 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria. Clinical information and Sociodemographic data were retrieved from the medical records of the patients. Structured history and clinical examination was performed on all patients as per the study proforma. Administration of Lupus quality of life questionnaire was done and all patients had nerve conduction studies performed. Data was analyzed using version 25.0 of SPSS. Results: Peripheral neuropathy prevalence was 60.4 %( 29 out of 48).Twenty seven point one percent (13) of them had abnormal nerve conduction studies and were symptomatic for peripheral neuropathy while 25 %( 12) had normal nerve conduction studies despite being symptomatic for peripheral neuropathy. Whereas 8.3 %( 4) were asymptomatic and had abnormal nerve conduction studies. Demyelination was the most common nerve conduction pathology at 9(52.94%, n=17). Nevertheless on excluding 5 patients found to have carpal tunnel syndrome, then 4(23.52% n=17) patients had demyelination. Whereas 5(29.41% n=17) patients were found to have axonopathy. Motor neuropathy was the most prevalent nerve conduction syndrome at 52.94% (n=17). The correlation between the presence of peripheral neuropathy with lower quality of life scores involving the domains of physical health (p=<0.001), pain (p=0.012), planning (p=0.003), and fatigue (p=0.005) was significant. xii Conclusion: Among SLE patients there is a high prevalence of peripheral neuropathy, with variable electrophysiologic and clinical presentation. In affected patients, Quality of life is scores are lower.