peripheral neuropathy and scleroderma
 

Hello
can any one tell me how common peripheral neuropathy is with scleroderma?

It's not all that common--
 

--but in can happen, simply because of the compressive forces on nerve from changing skin and connective tissue from the syndrome:

http://neuromuscular.wustl.edu/antib...ml#scleroderma

Scleroderma also affects circulation to the fingers and toes.

I had a patient with this problem, and her hands were turning BLACK and her doctor was discussing amputation after all the drugs tried failed.

She took my advice and did epsom salt soaks for her hands and they started to get better. So I moved her up to oral magnesium (SlowMag), and natural vitamin E to improve her blood flow, and she reversed almost 100%. She had some purple cast now and then, but for the most part her hands were much more normal.
When circulation gets this poor the nerve ending can die off from lack of glucose and oxygen and from the build up of toxins from energy metabolism of the tissues.

So poor circulation from ANY cause is a prime candidate for PN in the hands and feet IMO.

Sclerodera -
 

both localized and systemic. A good article explaining it. I know someone just diagnosed with localized scleroderma and the sister has Raynaud's. One of my friends died from systemic scleroderma, RA, and Lupus.

http://en.wikipedia.org/wiki/Scleroderma

http://www.webmd.com/pain-management/scleroderma

And there is pain big time for person the I know and for my friend who died.

thank you so much glenntaj, I will use this link.
I had vasculitis rash like the one on the picture, but in much smaller scale. had it twice. some doctors have questioned it due to negative labs.
For 12 months now the neuropathy has been getting worse and worse. Burning everywhere. I have had chest tightness for 1 year. now for last 2 months worse. Had all tests and tried GI meds. Awaiting result from Manometry studies. Bronchoscopy 2 days ago showed bronchial stenosis. Having shortness of breath. The pulmonologist does not think it is Wegeners.
And Echocardiogram now showing leaking of 3 valves, and left ventricular diastolic dysfunction. they say it is due to age. So I do not know, possible it could be scleroderma causing the neuropathy ( antibodies negative) I have developed thousands of little hard bumps on legs and arms just under skin little faint light purplich color. I have not brought this to doc's attention, thinking it was something due to Plavix. I do have Levido Reticularis.
So, I am awating a special neurologist next week re neuropathy, I will request a punch nerve biopsy. What do you think? I should find the cause of the neuropathy. So if it is Wegeners, I need strong meds sooner than later. The neuropathy is so bad, ( I am taking Lyrica 400 mg a day)that I think possibly not scleroderma , it is probably due to the vasculitis. Thanks for yopur input, I will study the link.
Synnove

Thank you Mrs. D
See above input for comments on glennlaj's
I will try the natural Vitamin E. for the skin My neuropathy is not only in distal part like hands and feet, and I do not have the dicoloration of fingers, The neuropathy is all over, scalp,face, mouth lips an mucous membrane. That is why I am pushing the doctors to find out.

You should look at all the drugs you are taking. Drug induced lupus happens, and can give normal ANA testing results.

When I had my recent crisis with Lisinopril I had burning eyes, and everywhere. I am now recovering from that, but slowly.
http://www.lupus.org/webmodules/weba...=377&zoneid=17

This test is more accurate for diagnosing lupus that results from prescription drugs:
http://en.wikipedia.org/wiki/Anti-histone_antibodies

Have taken Cipro a few times, but when thinking back, think it was after the neuropathy started.
Question: How does Nitrrofurantion compair to Cipro when it comes to the neuroropathy triggers? This would be good to know for the future.
Had stopped Lipitor for a while, but it made no difference in burning symptoms.
Thanks for the link, I have copied the list of meds.
Thanks

Nitrofurantoin is also on the list of PN triggers. However, most of the studies about it on PubMed, claim it reverses when the drug is stopped. It may take weeks/months however.

There is a total lack of evidence of the PN from statins reversing.
The medical community seems to ignore this still. Most of the people coming here with PN who used statins, do not see much improvement after stopping them. I think it depends on how long the drug was taken, and which type and at what dose. The lipophilic statins seem to be the most damaging. Zocor, for example. Lipitor is partially lipophilic and therefore, may be less toxic, but IMO all of them are suspect.

Statins have recently been shown to block remyelination of nerve axons, in the brain. Whether this is permanent or not, has not
been fully explained yet.

Everyone on a statin drug should be replacing the lost CoQ-10 with a quality product that is well absorbed. Statins block CoQ-10 synthesis in the liver which is part of the same pathway that cholesterol synthesis shares.

Are you having continued urinary tract infections? There are other drugs to try for that. Duricef and doxycycline do not have the PN warnings.

At one point statins were suggested for multiple sclerosis, and this study demonstrated that they actually make the lesions worse and not better. So this treatment has been dropped in MS patients.
http://www.ncbi.nlm.nih.gov/pubmed/19349355
and:
http://www.jneurosci.org/content/28/50/13609.full.pdf

This would happen in other people as well. And also at peripheral sites, lipophilicity would be less of an issue, because there is no blood brain barrier to get across. Lipophilic means more soluble in fat, and since nerve tissue is high in fat, lipophilic statins cross the blood brain barrier better than others. But in the peripheral areas of the body, there is no barrier so the statins are present at nerves more easily.

This article claims PN may be reversed.
http://care.diabetesjournals.org/con.../8/2082.1.full
But I think that is probably variable, since everything appears
to be variable with PN.
I notice also in this paper, that the described patient was using metronidazole, which is also a PN trigger and damaging.

Thank you Mrs. D.
Well, I have a little complicated situations/conditions at present, some diagnosed, some not. And it seems like one have to figure out a lot self. But my neurointerventional doctor, who had been serving also as my general neurologist, did suggest that I stop Lipitor due to neuropathy. I was taking Lipitor, generic version. He also have referred me to a neurologist at a teaching university hospital who specializes in neuropathies.
I also have some strange vibration down my spinal cord, and I hope this doctor can help. This must come from some demyelating lesions I have in brain. Have been tested for MS, will continue to monitor
.
Yes, I have had soe recurring UTI. I have a neurogenic bladder.

Question:
Could the neurogenic bladder( which I have diagnostic positive test for) be considered as a mononeuritis multiplex?

Together with the fact that I had very acute brachial neuritis,with musle and nerve involvement. ?? could this be specified as a neuritis multiplex?