ANCA関連血管炎による末梢神経障害の診断と治療

Diagnosis and Treatment of Peripheral Neuropathy Induced by ANCA-associated Vasculitis

ANCA関連血管炎に伴う末梢神経障害は，末梢神経を栄養する小型血管を標的に壊死性血管炎が生じ，虚血性の機序により軸索変性による障害が惹起されることによって起こる。運動機能障害のみならず感覚障害や疼痛のため日常生活機能や生活の質に重大な影響を及ぼす。末梢神経系はANCA関連血管炎の主たる病変部位であることを十分に認識して，迅速な早期診断と適切な治療介入が肝要である。

Abstract

ANCA-associated vasculitis is induced by necrotizing angiitis of small vessels supplying the peripheral nervous system. Ischemic processes induce neuronal damage and axonal degeneration in the peripheral nerve. Motor dysfunction as well as sensory disturbance and allodynia caused by neuropathic symptoms may influence an individual's activities of daily living and quality of life. Notably, the peripheral nerve is predominantly affected in ANCA-associated vasculitis. We suggest that early diagnosis and appropriate treatment are important to improve survival in and functional prognosis of ANCA-associated vasculitis.