Subclinical Peripheral Neuropathy in Patients with Rheumatoid Arthritis / 대한류마티스학회지

ABSTRACT

OBJECTIVE: Symptomatic neuropathy is uncommon in rheumatoid arthritis (RA) but, compression neuropathy and vascular neuropathy were reported in longstanding RA. To investigate the occurrence of electrophysiologically evident peripheral nerve involvement in RA patients without a clinical manifestation of peripheral nerve involvement, we studied nerve conduction velocity study (NCV) in RA patients without symptomatic neuropathy. Twenty-five RA patients were evaluated neurological examination and by NCV. We compared clinical parameters between electrophysiologic positive group and negative group. There was no patient who had neurologic symptoms or signs of peripheral involvement. Eleven patients (44%) of all exhibited NCV findings consistent with distal symmetrical sensorimotor polyneuropathy, 5 patients (20%) had entrapment neuropathy, 2 patients (8%) showed distal symmetrical sensory polyneuropathy, 1 patient (4%) had digital neuropathy, and 6 patients (24%) had normal NCV. CONCLUSION: Patients with RA may have electrophysiologic peripheral nerve damage, even in the absence of clinical evidence of peripheral nerve involvement. There was no correlation with any clinical parameters. The inclusion of electrophysiologic examination of the RA patients is recommended in routine diagnostic procedures.