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Prevalence of Peripheral Neuropathy in Rheumatoid Arthritis

BACKGROUND : Rheumatoid arthritis is a systemic autoimmune disease predominantly affecting the joints and is also associated with extra articular manifestations like episcleritis, carditis, interstitial lung disease, peripheral neuropathy etc. The presence of peripheral neuropathy contributes significantly to the functional limitation in rheumatoid arthritis patients. 
OBJECTIVES : To detect the prevalence, types and determinants of peripheral neuropathy in patients with rheumatoid arthritis. 
MATERIALS AND METHODS : We studied 50 patients with rheumatoid arthritis for 2 years duration, for the presence of peripheral neuropathy both clinically and electrophysiologically. 
The data obtained were entered into a database and Chi-square test was 
used to compare the associations between the dependent variables and Levene’s T test was used to compare the association between the independent variables. 
RESULTS : Peripheral neuropathy was detected in 74% (37 out of 50 RA patients) on electrophysiological testing of which, 73% were asymptomatic. There was significant association between the presence of peripheral neuropathy and disease duration & rheumatoid factor positivity. Non-compressive neuropathy was found to be most common type, of which mixed sensory motor neuropathy affecting the lower limbs was predominant (50%). 
CONCLUSION : Our study shows that subclinical peripheral neuropathy particularly mixed sensory motor neuropathy is very common in patients with prolonged RA disease duration. Performing nerve conduction studies as screening tests in all RA patients during follow-up visits leads to early detection of neuropathic changes, thereby preventing the development of debilitating comorbidities by taking appropriate early measures.