Senthilnathan Subbiah, Nallusamy Gunasekaran, Varadaraj Priyadarshini, Reddy Keesari Sai Sandeep, Kumar Lokesh
Internal Medicine, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
General Medicine, Adyar Cancer Institute, Chennai, IND.
Cureus. 2024 Oct 1;16(10):e70649. doi: 10.7759/cureus.70649. eCollection 2024 Oct.
Peripheral neuropathy, characterized by nerve damage, often presents with symptoms like pain, tingling, and muscle weakness. However, in its subclinical form, these symptoms may be subtle or absent, making early detection challenging. This is particularly concerning in patients with autoimmune connective tissue disorders (ACTDs), where the immune system attacks the body's tissues, potentially leading to nerve damage. Early identification and management are crucial to prevent the progression from subclinical to clinical neuropathy, which can significantly impair quality of life.
This prospective cross-sectional study involved 100 patients with ACTDs of three or more years' duration, conducted at Saveetha Medical College over 15 months. Nerve conduction studies (NCS) were performed on bilateral ulnar, radial, sural, peroneal, and tibial nerves.
Peripheral neuropathy was present in 18 (18%) of the study participants. Carpal tunnel syndrome was the most prevalent type, affecting 10 (55.56%) of those with neuropathy. Significant differences were found in the left peroneal motor nerve (p = 0.003) and right tibial nerve (p = 0.03) conduction times. Additionally, significant associations were observed between rheumatoid factor positivity (p = 0.011), anti-cyclic citrullinated peptide (anti-CCP) antibody status (p = 0.032), and the presence of peripheral neuropathy.
This study underscores the importance of early detection and intervention for peripheral neuropathy in patients with ACTDs. The study's findings align with existing literature, suggesting that a substantial proportion of patients with ACTDs are at risk for peripheral neuropathy, particularly in older patients and those with specific autoimmune markers. Regular NCS assessments are recommended to identify at-risk individuals, potentially mitigating the progression of neuropathy and improving patient outcomes. Future research should include larger, more diverse populations and longitudinal studies to further validate these findings.
以神经损伤为特征的周围神经病变,常表现为疼痛、刺痛和肌肉无力等症状。然而,在其亚临床形式中,这些症状可能很轻微或不存在,这使得早期检测具有挑战性。这在自身免疫性结缔组织病(ACTDs)患者中尤其令人担忧,在这类疾病中,免疫系统会攻击身体组织,可能导致神经损伤。早期识别和管理对于预防从亚临床神经病变发展为临床神经病变至关重要,因为这会显著损害生活质量。
这项前瞻性横断面研究在萨维塔医学院进行了15个月,涉及100例病程超过三年的ACTDs患者。对双侧尺神经、桡神经、腓肠神经、腓总神经和胫神经进行了神经传导研究(NCS)。
18名(18%)研究参与者存在周围神经病变。腕管综合征是最常见的类型,在患有神经病变的患者中有10名(55.56%)受影响。左侧腓总运动神经(p = 0.003)和右侧胫神经(p = 0.03)的传导时间存在显著差异。此外,类风湿因子阳性(p = 0.011)、抗环瓜氨酸肽(抗CCP)抗体状态(p = 0.032)与周围神经病变的存在之间存在显著关联。
本研究强调了对ACTDs患者周围神经病变进行早期检测和干预的重要性。该研究结果与现有文献一致,表明相当一部分ACTDs患者有周围神经病变的风险,特别是老年患者和那些具有特定自身免疫标志物的患者。建议定期进行NCS评估以识别高危个体,这可能减轻神经病变的进展并改善患者预后。未来的研究应纳入更大、更多样化的人群并进行纵向研究,以进一步验证这些发现。