NEUROLOGICAL COMPLICATIONS IN PATIENTS WITH RA | Arthritis Information
AB0153 NEUROLOGICAL COMPLICATIONS IN PATIENTS WITH RHEUMATOID ARTHRITIS (RA)
A. Ebrahimi*1, S. Sadreddini2, H. Noshad3, M. Molaeefard3, M. Yasdchi-Marandi3
1rheumatology, Tabriz university (medical sciences), 2Rheumatology, 3rheumatology, Tabriz university of medical sciences, Tabriz, Iran (Islamic Republic of)
Background: Rheumatoid arthritis (RA) is a systemic chronic disease with potential multi organ damage. Its prevalence estimated about 1-3 % in general population. Involvement of lung, heart, eye, kidney and nervous system are some of its extra-arthicular manifestations. Neurological symptoms divided in two types; central and peripheral. Involvements of cervical spinal cord are the main central nervous system (CNS) manifestation in RA. More and better knowledge of neurological involvement help us for early diagnosis and treatment of these complications.
Methods: Seventy patients with RA (diagnosed according to ACR, criteria, 1987) enrolled in a prospective descriptive study from March 2004 to Aug 2006 in Tabriz medical university. Cervical X-Ray (AP & Lat) and upper and lower limbs electro-diagnostic tests were performed for all of the patients. The patients were divided to four stages based on ACR revised criteria for classification of global functional status in RA, 1991.
Results: From 70 patients entered in this study, 71.4% were female and 28.6% male with mean age of 50.24 _ 14.9 years. The mean age for initiation of presenting symptoms was 41.22 _ 15.02. The most common clinical symptom and arthritis were morning stiffness (84.3%) and wrist involvement (75.8%). Erythrocyte sedimentation rate (ESR) was increased in 54.3%. C.reactive protein (CRP) and rheumatoid factor (RF) were positive in 61.5 and 51.1% of patients, respectively. 4% of patients were in stage I, 48.9% in stage II, 25.2% in stage III and 21.9 in stage IV. Our results showed neurological involvement in 57.1% that in 23.2% was central and in 33.9% was peripheral. The most common CNS manifestations were lower cervical spine involvement (11.2%), cervical radiculopathy (8.1%) and atlantho-axial damage (3.9%). The most common peripheral nerve symptoms were nerve entrapment (19.2%) and sensory polyneuropathy (12.1%).
Carpal tunnel syndrome was the most common type of nerve entrapment (11 patients). There was a significant relation between CNS involvements with stage of disease (P = 0.03) and also between nerve entrapments with ESR (P < 0.01). Totally there was not significant relation between peripheral nerve involvement and stage of disease.
[QUOTE=Lynn49]Involvement of lung, heart, eye, kidney and nervous system are some of its extra-arthicular manifestations. Neurological symptoms divided in two types; central and peripheral. Involvements of cervical spinal cord are the main central nervous system (CNS) manifestation in RA. More and better knowledge of neurological involvement help us for early diagnosis and treatment of these complications.[/QUOTE]
Once again we are presented with a clear acknowledgement of the necessity of not only early and aggressive treatment, but also the importance of being aware of all the potentials of the disease.
Thanks again for keeping us informed and current!
Amen to all of that!!
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