Treatment For Vasculitic Neuropathy?
last month i was diagnosed as vasculitic neuropathy..can you tell me the guidelines of treatment
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**Treat systemic vasculitic neuropathy and nonsystemic vasculitis with a combination of prednisone and cyclophosphamide or, less commonly, azathioprine (Imuran), methotrexate, and intravenous immunoglobulin.
- Take prednisone for 2-3 months or until clinical beneficial effect is noted; then taper gradually according to clinical/symptomatic response. The typical starting dose is 40-100 mg daily, which is eventually tapered to every other day dosing to avoid side effects. Cyclophosphamide is started at 100-150 mg daily.
- Continue treatment for 6 months to 1 year or longer. Some patients may require long-term immunosuppression for years.
- Discuss adverse affects and toxicity of long-term use of corticosteroids and immunosuppressive agents with your treating doctor prior to onset of therapy.
** Symptomatic treatment of neuropathic pain can be initiated with amitriptyline and/or nortriptyline, carbamazepine, or gabapentin. Other systemic manifestations of systemic vasculitis require management according to organ involvement and specialty consultation.
I suggest you get the opinion of a neurologist or an internist before you follow through the above guidelines.
Hope this helps and wish you the best.
Dr. Nsah
is this dose heavy or normal..kindly guide me
Yes methylprednisolone (solu-methrol) injection can be used and the dose of 1g IV is allowed daily. But be rest assured that you will derive the same benefit if you considered oral route instead of parenteral route. The only difference is you will have to go through a session of 4-6hrs every 5 days for three months when placed on parenteral where as oral treatment, you could be ambulatory while taking your treatment. Each route has both its benefits and it disadvantages and I believe your doctor can sit you down and explain the benefits (Note that you are also free to choose which route suits you).
Hope this helps and wish you the best.
Dr. Nsah
i consulted 2 neurologists and they said like that,,its better to take parentral therapy than oral one
Like I said both have advantages and disadvantages. Side effects are more for oral than parental as it is given in sessions and not daily. You may go in for the parenteral (you will have little or no side effects). I did only try to provide you with a treatment guideline as you requested and I gave you WHO recommendation (1st line treatment).
Hope this helps and wish you the best.
Dr. Nsah