Quote:
Originally Posted by glenntaj
--especially of the small fibers, have a vascular component to them; diabetic neuropathy is usually thought of as mainly ischemic in nature, in that the nerves that control the smaller blood vessels are affected, but this can work the other way around, as well, in that damage to small blood vessels may make nerves that depend on them for oxygen, nourishment, and waste removal may be compromised and thus cause damage to the function of the nerves. This also happens in many autoimmune neuropathies, particularly those associated with the anti-nuclear antibody conditions in the lupus/rheumatoid arthritis family of diseases.
It may be hard to pull apart the effects of blood vessel problems from the effect on nerves vs. the effect of nerve problems on blood vessels--they are often conflating and mutually reinforcing, like a feedback loop. Obviously, one wants to arrest the processes going on so both get a chance to heal, if that's possible.
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Thanks for this helpful explanation. As an artist I do like to be able to visualise these things which is why I asked here rather than on the Sjögren’s forum. The vascular doctor explained that, in my case it’s the small nerves that are damaged and are precipitating a vascular response, rather than the other way around.
I do have a high ANA and high inflammation markers so my neuropathy is presumed to be Autoimmune, relating to my seronegative (ie lip biopsy positive) Sjögren’s. For this I’m on the maximum dose of Mycophenolate/ Cellcept but it doesn’t appear to be doing much for the neuro symptoms. I’m told this is probably due to small vessel and nerve damage having already occurred so it’s being used as a deterrent for arthralgia and potential organ involvement and vasculitis.
I also have presumed ganglionopathy/ autonomic dysfunction but where I live there are no tests they can run to confirm so it’s all just presumed as part of the neuro Sjögren’s.