Vasculitic neuropathy.

The pathogenesis of primary vasculitides, which are assumed to have an autoimmune pathogenesis, is not well understood. The endothelial cell adhesion molecules seem to play an active role, which varies according to the histopathologic stage of vascular lesions. The role of genetic factors also seems quite important, at least in an experimental model. The reliability of antineutrophil cytoplasmic antibodies testing in diagnosis and follow-up of patients with vasculitis is reviewed. The conclusion is that antineutrophil cytoplasmic antibodies status can be a very useful diagnostic adjunct to the evaluation of patients with suspected Wegener's granulomatosis, but is not a substitute for clinical expertise and histopathologic data during the course of providing patient care. The neurological manifestations of Churg-Strauss syndrome (a variant of polyarteritis nodosa) are very similar to those that occur in polyarteritis nodosa. A role for vasculitis has been confirmed in proximal diabetic neuropathy, which may pave the way for new therapeutic developments.