Asociación entre la granulomatosis de Wegener y el dolor lumbar severo

Abstract

Introduction: Wegener’s granulomatosis (WG) is a systemic autoimmune disease characterized by necrotizing granulomatous vasculitis which primarily affects upper respiratory tract, lungs and kidneys. However, less frequently can affect muscles, joints, skin, eyes, cardiovascular system and nervous system. The presence of lumbar pain consists in an unusual clinical manifestation due to the involvement of the nervous system. Objective: The objective of this study is to alert health professionals about the possibility that severe lumbar pain be related to Wegener’s granulomatosis, it’s impact on the patient’s daily life as well as clinical signs and diagnosis forms. Materials and Methods: Literature review using PubMed, MEDLINE, Google Scholar, SciELO, EBSCO. Selected works from 1995 to 2013 totaling 48 works of which 21 were selected according to their reports of neurological involvement, diagnosis and treatment. Discussion: Neurological symptoms may occur in 22-50% of Rheumatopatients during the course of WG. Central nervous system (CNS) involvement is uncommon (only 2-8% of patients). Severelumbar pain is a rare clinic manifestation and it can be associated with the involvement of central and peripheral nervous system. CNS due to compression of the spinal cord at the lumbar level. Peripheral nervous system due to compression of nerve roots. Conclusion: Wegener’s granulomatosis for being a systemic disease can present different clinical manifestations according to the involved site. It’s associations with lumbar pain is rare and reflects it’s neurological involvement. Therefore, in patients with severe lumbar pain without confirmed diagnosis, Wegener’s granulomatosis should be considered.