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Background <p>Peripheral neuropathy is a frequently overlooked extra-articular manifestation of Rheumatoid Arthritis (RA). Early detection, especially of subclinical neuropathy, is critical to prevent long-term disability. This study aimed to evaluate the prevalence and type of neuropathy in RA patients and its correlation with clinical disease activity.</p> Materials and methods <p>A cross-sectional observational study was conducted on 54 RA patients diagnosed as per ACR/EULAR 2010 criteria at SRN Hospital, MLN Medical College, Prayagraj India. Patients with diabetes, alcohol use, or hypothyroidism were excluded. All participants underwent detailed clinical examination, Disease Activity Score-28 (DAS28-ESR) assessment, and motor and sensory nerve conduction studies (NCS). Correlation between neuropathy and clinical parameters including disease duration and DAS28 scores were analyzed.</p> Results <p>Neuropathy was detected in 72.22% (39/54) patients, of which 25% (4/16) of asymptomatic individuals had subclinical neuropathy (7.4% of the total population). The most common neuropathy type was mixed (48.15%), followed by axonal (18.52%) and demyelinating (7.41%). Specific neuropathies included carpal tunnel syndrome (18.52%) and mononeuritis multiplex (9.26%). Mean DAS28 score was significantly higher in patients with neuropathy (5.65 ± 0.84) compared to those without (4.04 ± 0.96, <i>p</i> = 0.0038). No statistically significant correlation was found between neuropathy type and disease duration (<i>p</i> = 0.85) or DAS28 categories (<i>p</i> = 0.48).</p> Conclusion <p>Peripheral neuropathy is highly prevalent in RA, including a notable percentage of subclinical cases. Higher disease activity scores correlate with neuropathy presence. Routine neurophysiological screening should be considered, especially for patients with high DAS28 scores.</p>

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Mapping the Neurological Footprint of Rheumatoid Arthritis and Clinical Implication of Neuropathy and Electrodiagnostic Study: A Wake-up Call for Clinicians

  • 期刊论文

  • 发表日期：

    2025年12月29日

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  • Ajeet Kumar Chaurasia,
  • Balaga Karthik,
  • Poonam Gupta,
  • Archana Ojha

摘要

Background

Peripheral neuropathy is a frequently overlooked extra-articular manifestation of Rheumatoid Arthritis (RA). Early detection, especially of subclinical neuropathy, is critical to prevent long-term disability. This study aimed to evaluate the prevalence and type of neuropathy in RA patients and its correlation with clinical disease activity.

Materials and methods

A cross-sectional observational study was conducted on 54 RA patients diagnosed as per ACR/EULAR 2010 criteria at SRN Hospital, MLN Medical College, Prayagraj India. Patients with diabetes, alcohol use, or hypothyroidism were excluded. All participants underwent detailed clinical examination, Disease Activity Score-28 (DAS28-ESR) assessment, and motor and sensory nerve conduction studies (NCS). Correlation between neuropathy and clinical parameters including disease duration and DAS28 scores were analyzed.

Results

Neuropathy was detected in 72.22% (39/54) patients, of which 25% (4/16) of asymptomatic individuals had subclinical neuropathy (7.4% of the total population). The most common neuropathy type was mixed (48.15%), followed by axonal (18.52%) and demyelinating (7.41%). Specific neuropathies included carpal tunnel syndrome (18.52%) and mononeuritis multiplex (9.26%). Mean DAS28 score was significantly higher in patients with neuropathy (5.65 ± 0.84) compared to those without (4.04 ± 0.96, p = 0.0038). No statistically significant correlation was found between neuropathy type and disease duration (p = 0.85) or DAS28 categories (p = 0.48).

Conclusion

Peripheral neuropathy is highly prevalent in RA, including a notable percentage of subclinical cases. Higher disease activity scores correlate with neuropathy presence. Routine neurophysiological screening should be considered, especially for patients with high DAS28 scores.