Vasculitic Neuropathy Treatment: Immunosuppression and Supportive Care

Treatment targets underlying vasculitis (e.g., PAN, ANCA-associated, rheumatoid, lupus).

Standard Regimen

• Induction: High-dose glucocorticoids (prednisone 1 mg/kg) + cyclophosphamide or rituximab for severe disease.
• Maintenance: Azathioprine, methotrexate, mycophenolate, or rituximab.
• Adjuncts: IVIG for refractory cases; plasma exchange for severe renal/pulmonary involvement.

Supportive

• Neuropathic pain: gabapentin, duloxetine, TCAs.
• Physical/occupational therapy for weakness.
• Smoking cessation, cardiovascular risk reduction.

Early aggressive treatment improves neurologic recovery.