Clinical characteristics of rheumatoid arthritis patients with peripheral neuropathy and potential related risk factors.

Objectives: To investigate potential risk factors of peripheral neuropathy (PN) in rheumatoid arthritis patients (RA).

Methods: Eighty-eight patients with RA were enrolled in this study, including patients with PN (n = 44; 28 patients with multiple nerves (MN) involvement and 16 patients with single nerve (SN) involvement) and without (n = 44) peripheral neuropathy were enrolled. Their clinical features were comprehensively collected including symptoms/signs, lab results, electromyogram data. T test or chi-squared test and further binary regression analysis were used to explore risk factors based on analyzing these clinical features.

Results: There was no difference as regards patients' age (59.50 ± 8.11 vs 58.68 ± 11.44 years), gender ratio (female/male, 29:15 vs 29:15), and disease duration (6.34 ± 7.87 vs 8.13 ± 9.52 months) between patients with and without PN. RA patients with PN had lower total protein (61.13 ± 7.06 vs 66.06 ± 6.44 g/L), anti-CCP levels (239.13 ± 203.77 vs 361.41 ± 168.09 U/ml) compared with control patients, while patients with MN had higher inflammatory parameters (white blood cells, platelet, C-reactive protein (CRP), erythrocyte sedimentation rate, rheumatoid factor) than patients with SN (p < 0.05). Low total protein (< 63 g/L, 30/44 vs. 12/44) and anti-CCP (< 285.7 U/ml, 27/44 vs. 11/44) were risk factors for patients with PN, while CRP (> 6 mg/L, 26/28 vs. 6/16) and PLT (> 243 × 10/L, 25/28 vs.5/16) were related to the development of MN.

Conclusions: RA patients with PN, especially MN can present various clinical symptoms, which will aggravate patients' anxiety and depression status. The increase of blood platelet, and CRP levels and decrease of blood albumin are probable risk factors for PN in RA patients.