Peripheral neuropathy in rheumatoid arthritis patients: an electroneurophysiological study/ Romatoid artritli hastalarda periferik noropati: elektronorofizyolojik calisma

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Authors: Lale Akbulut Aktekin, Hilmi Gozlukaya, Hatice Bodur, Pinar Borman and Ozlem Koz
Date: June 2009
From: Turkish Journal of Rheumatology
Publisher: Turkish League Against Rheumatism
Document Type: Report
Length: 3,127 words
Abstract :

Objective: The aim of this study was to evaluate the frequency of peripheral nervous system involvement with electrophysiological studies in rheumatoid arthritis (RA) patients whose neurological examination findings were within the normal range. Material and Methods: Fifty-six RA patients and 32 healthy control subjects were included. Demographic characteristics, duration of disease and drug use of the patients were recorded. Laboratory variables and Ritchie articular index were used to evaluate disease activity. Electrophysiological studies were performed in all patients and control subjects. Median, ulnar and peroneal nerve motor nerve conduction studies (CVs), F wave, and median, ulnar, and sural nerve sensory CVs were recorded. Results: The frequency of neuropathy was higher in the patients with RA than in the control group. Neuropathy was detected in 20 (36%) RA patients: 3 (5%) had sensorimotor polyneuropathy, 7 (13%) had low sural sensory nerve conduction or absence of action potentials, 2 (4%) had carpal tunnel syndrome, 6 (11%) had low amplitude peroneal compound muscle action potentials, 1 (2%) had low amplitude peroneal compound muscle action potential and low ulnar sensory nerve conduction, and 1 (2%) had low sural and ulnar sensory nerve conduction. Neuropathy was determined in 5 of 13 patients using corticosteroids and in 15 of 43 patients who were not using corticosteroids. There was no statistically significant difference between the electrophysiologic findings of subgroups in terms of the corticosteroid therapy and positivity of Schirmer test and rheumatoid factor. There was no correlation between the electrophysiological parameters and disease activity in patients with RA. In the control group, 2 (6%) cases had electrophysiologically determined neuropathy; frequency of neuropathy was higher in the patients with RA when compared with the control group, and the difference was statistically significant (p Conclusion: Clinical evaluation of neuropathy in RA patients is difficult since neuropathic symptoms are frequently confused with arthritis. To detect neuropathy earlier in patients with RA, electrophysiological studies are recommended as routine diagnostic procedure even in the absence of clinical nerve involvement. (Turk J Rheumatol 2009; 24: 62-6) Key words: Rheumatoid arthritis, neuropathy, ENMG Amac: Bu calismanin amaci, norolojik muayenesi normal olan Romatoid Artrit'li (RA) hastalarda periferik sinir sistemi tutulumunun elektrofizyolojik calismalarla degerlendirilmesidir. Yontem ve Gerecler: Calismaya 56 RA'li hasta ve 32 saglikli kontrol dahil edildi. Hastalarin demografik ozellikleri, hastalik sureleri ve kullandiklari ilaclar kaydedildi. Hastalik aktivitesini belirlemede laboratuvar verileri ve Ritchie Artikuler Index (RAI) kullanildi. Tum hastalar ve kontrol grubunda, median, ulnar, and peroneal sinir motor sinir iletim calismalari, F dalga latansi ve median, ulnar, and sural sinir duyu sinir ileti calismalari kaydedildi. Bulgular: Elektrofizyolojik olarak noropati sikligi RA'li hasta grubunda kontrol grubuna gore daha sikti. RA'li hastalarin 20'sinde (%36) noropati tespit edildi. Uc hastada (% 5) sensorimotor polinoropati, 7 hastada (% 13) sural sinir duyu ileti hizinda yavaslama veya duyusal aksiyon potansiyeli elde edilememe, 2 hastada (%4) karpal tunel sendromu, 6 hastada (%11) peroneal sinir bilesik kas aksiyon potansiyeli amplitudunde azalma, 1 hastada (%2 ) peroneal sinir bilesik kas aksiyon potansiyeli amplitudunde azalma ve ulnar sinir duyu iletiminde yavaslama ve 1 hastada (% 2) ulnar ve sural duyu iletiminde yavaslama tespit edildi. Kortikosteroid tedavi alan, almayan ve Schirmer testi ile romatoid faktor pozitifligine gore hastalar gruplandirildiginda noropati yonunden istatistiksel anlamli farklilik tespit edilmedi. Elektrofizyolojik parametreler ile hastalik aktivitesi arasinda da korelasyon tespit edilemedi. Kontrol grubunda 2 kiside (%6) elektrofizyolojik olarak noropati tespit edildi, RA'li hastalarla karsilastirildiginda aradaki farklilik istatistiksel olarak anlamli idi (p Sonuc: RA'li hastalarda noropatinin klinik olarak degerlendirilmesi siklikla norolojik semptomlarin artrit nedeni ile ayirt edilememesi yuzunden zordur. RA'li hastalarda noropatinin erken taninabilmesi icin, klinik olarak tutulum olmasa bile elektrofizyolojik calismalarin rutin tanisal yontem olarak kullanilmasi onerilmektedir. (Turk J Rheumatol 2009; 24: 62-6) Anahtar sozcukler: Romatoid artrit, Periferik noropati, ENMG

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Source Citation
Aktekin, Lale Akbulut, et al. "Peripheral neuropathy in rheumatoid arthritis patients: an electroneurophysiological study/ Romatoid artritli hastalarda periferik noropati: elektronorofizyolojik calisma." Turkish Journal of Rheumatology, 2009, p. 62+. Accessed 9 July 2020.
  

Gale Document Number: GALE|A221761164