High blood pressure and a skin condition characterized by a netlike pattern of reddish-blue skin discoloration — livedo reticularis — may be risk factors for peripheral nervous system manifestations in systemic lupus erythematosus, a retrospective study suggests.

The study, “Peripheral nervous system involvement in systemic lupus erythematosus: a retrospective study on prevalence, associated factors and outcome,” was published in Lupus.

The nervous system is made up of two components: the central nervous system (CNS), which includes the brain and spinal cord, and the peripheral nervous system (PNS), which encompasses nerves and neurons that reside or extend outside the brain and spinal cord to innervate organs, muscles, blood vessels, and glands.

SLE can affect both the central and peripheral nervous systems, and research suggests that disorders of the PNS in SLE are a major cause of morbidity.

Nonetheless, “to date, little is known about the actual prevalence of PNS involvement in SLE (PNSLE) or the demographic and specific immunological factors associated with this type of involvement,” investigators said.

Using 14 years (2000-2014) of patient records, investigators from the University of Ferrara in Italy set out to determine the prevalence of peripheral nervous system involvement in 1,224 SLE patients. Researchers made sure to distinguish between manifestations caused by SLE from non-SLE ones.

Eighty-five (6.9%, mostly women) of the 1,224 patients had experienced at least one peripheral nervous system manifestation. A total of 97 PNS events were reported.

“In two cases, the event preceded the diagnosis of SLE, and in 26 patients, PNS involvement appeared at the onset of the disease, while in the remaining 57 patients, PNS involvement appeared more than three months after the diagnosis of SLE,”

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