AUTONOMIC NERVE DYSFUNCTION IN SYSTEMIC LUPUS-ERYTHEMATOSUS - EVIDENCE FOR A MILD INVOLVEMENT

Neurologic manifestations are known to occur in patients with systemic lupus erythematosus (SLE) and significantly affect the clinical cours e of the disease. Nevertheless, the prevalence, pattern and severity o f autonomic impairment in such patients have yet to be defined. In the present study a series of 38 female SLE patients was assessed for the presence of autonomic dysfunction. Five noninvasive standardized card iovascular reflex tests were used. The grading system proposed by Ewin g and Clarke was applied to classifying autonomic impairment according to severity. Seventeen out of 38 patients, that is 44.7%, had evidenc e of autonomic impairment. Most of the patients had a mild degree of d ysfunction. No correlation was found for the duration of the disease w hile an apparent lack of the commonly described chronological sequence of autonomic involvement was observed. We suggest that in SLE patient s the prevalence of autonomic impairment, when investigated, does not significantly differ from that of other SLE-associated neurological ev ents. The contribution of a direct immunological damage to components of neural pathways in the pathogenesis of the autonomic involvement ca n be postulated. Clinical consequences of autonomic impairment in pati ents with systemic lupus erythematosus need to be elucidated.