Clinical and biological factors associated with the presence of peripheral neuropathy in patients with rheumatoid arthritis.

Abstract

Objective: Immune dysfunction in rheumatoid arthritis (RA) is a contributing factor to the development of peripheral neuropathy (PN). The objective of our study was to investigate the biological and clinical factors associated with PN in patients with RA.

Materials and methods: We conducted a retro-prospective cross-sectional study. A total of 63 patients with RA were included. They were divided into two groups, 18 with PN and 45 without PN. Participants with PN were those with a pathological electroneuromyogram (ENMG) with or without signs and symptoms of PN. Blood samples were taken for the measurement of rheumatoid factor (RF) and C-reactive protein (CRP). The concentration of anti-citrullinated peptide antibodies (ACPA) were collected from patient records. The significance threshold was set at a p-value <0.05.

Results: The majority of participants, 82.5% were female. The mean age was 51.86 ± 13.07 years. PN was present in 28.6% of the participants. RF and ACPA were positive in 71.4 and 77.8% of the participants, respectively. Severely active RA was significantly associated with the presence of PN (p < 0.001, OR = 55.13). RF concentrations were significantly higher in patients with PN. The area under the ROC curve for RF concentration in predicting PN in patients with RA was 0.7 (AUC = 0.7), patients with an RF > 169.10 IU/mL had a significant risk of presenting PN (p = 0.003, OR = 8.20).

Conclusion: Severe rheumatoid arthritis is associated with PN. Inflammatory markers may play a key role in the pathogenesis and may provide valuable guidance for the early diagnosis of PN in RA.