Peripheral neuropathy in rheumatoid arthritis with special emphasis on nerve conduction studies

OBJECTIVE: To study the prevalence of peripheral neuropathy (PN) in rheumatoid arthritis patients and to investigate the relationship between electrophysiological findings of peripheral neuropathy and clinical findings of RA. METHODS: Rheumatoid arthritis patients were electrophysiologically examined for evidence of peripheral neuropathy. Study parameters including age, gender, laboratory parameters, duration of RA and medication, were recorded. RESULTS: Out of a total of 60 RA patients, 26(43%) had peripheral neuropathy: 2 had carpal tunnel syndrome, 6 had sensory polyneuropathy, 11 had sensorimotor polyneuropathy, 5 had motor neuropathy and 2 had mononeuritis multiplex.The mean ages of the patients were 45.85 and 36.65 years, respectively (p<0.05). A significant relationship was found between peripheral neuropathy and anti-cyclic citrullinated peptide (anti-CCP) antibody, RF, ESR, duration of RA. No relationship was found between peripheral neuropathy and neuropathic symptoms, gender and CRP. CONCLUSION: Neuropathic symptoms are common in RA patients. It is difficult to distinguish peripheral neuropathy symptoms from those of arthritis. Elderly patients, longer duration of RA and anti-CCP antibody positive patients with or without neuropathic symptoms should undergo electrophysiological studies.