AB1380 Peripheral neuropathy in inflammatory joint diseases

Abstract

BackgroundFor frequent extra-articular (systemic) manifestations of joints inflammatory diseases are various damage of the nervous system,2 and the presence and severity of peripheral neuropathy (PNP) have significance in the clinical course, which incidence among these patients is 5%–10%.1 Nevertheless, many clinical and pathogenic aspects of this peripheral neuropathy (PNP) remain obscure.Objectivesto evaluate the rate and clinical features of PNP in rheumatoid arthritis (RA), chlamydia urogenital reactive arthritis (ReA), psoriatic arthritis (PA) and ankylosing spondylitis (AS), to examine the issues of pathogenetic constructions such changes of the nervous system, define risk factors.MethodsThe study included 416 patients with inflammatory joint diseases, among them 131 RA patients, 101 ReA, 76 PA and 108 AS. The average age of the examined was respectively 45, 32, 42 and 38 years, disease duration – 10, 4, 12 and 11 years, male to female ratio – 1:5, 1:1, 1:2 and 10:1.ResultsThe frequency of the PNP in RA, ReA, PA and AS was 13%, 19%, 24% and 34%, while its severity in patients with PA <ReA < RA<AS, and the same type ratio of motor, sensory and mixed disorders of inflammatory joints diseases, trophic, visceral and vascular vegetative changes, the connexion with the male sex, the activity of arthritis and the presence of tendovaginitis, participation of immune disorders, endothelial dysfunction of blood vessels and changes in physical and chemical rheological viscoelastic properties of blood in the pathogenesis constructions of the nervous system lesions are united around. ReA and PA are different by frequency of hands and feet distal pathology, the AS – by the beginnings of tunnel syndrome. RA tends to impact on the PNP digital arteritis, myositis, eye disease, and Sjogren’s syndrome, ReA – on sacroiliitis, PA – on exudative form of cutaneous psoriasis, AS – on eye disease, at that, the risk factors for severe course of neuropathy in RA is considered to involve in the process of elbows, ReA – intervertebral and facet joints, PA – wrist, AS – sacroiliac. Guillain-Barré syndrome develops respectively in 3%, 4%, 5% and 9% of patients with RA, PA, ReA and AS, or in 24%, 17%, 26% and 27% cases of PNP, which is closely linked to the presence of tendovaginitis in all inflammatory diseases and severity of articular syndrome, in RA it depends on the presence of hypothyroidism, in ReA – on nephropathy and violations of the heart‘s electrical conduction, in AS – on osteoporosis, and seropositive for anti-cyclic citrullinated peptide antibody is a risk factor for such peripheral nervous system disorders.ConclusionsPNP is a relatively common manifestation of inflammatory diseases of the joints, which correlate with clinical and laboratory signs of the disease, and in the future such active detection of the nervous system pathology will be useful for timely follow-up rehabilitation.Reference[1] Oomatia A., Fang H., Petri M., Birnbaum J. Peripheral neuropathies in systemic lupus erythematosus: clinical features, disease ass...

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“…The pathophysiology of PN in rheumatoid arthritis involves genetic factors, environmental factors (toxins, chemicals, bacteria), etc. These factors attack the immune system causing damage to the tissue around joints of elbows, shoulders, neck, knees, and ankles, causing nerve damage ultimately leading to PN 32,37 . Patients with rheumatoid arthritis should regularly undergo electrophysiology testing to rule out the existence of peripheral neuropathy.…”