A Systematic Review of Peripheral and Central Nervous System Involvement of Rheumatoid Arthritis, Systemic Lupus Erythematosus, Primary Sjögren’s Syndrome, and Associated Immunological Profiles

Abstract

Both central (CNS) and peripheral nervous system (PNS) complications are frequent and varied in connective tissue diseases. A systematic review was conducted between 1989 and 2014 in the databases Medline, Scopus, and Cochrane Library using the search terms, peripheral and central nervous complications and immunological profiles, to identify studies in specific connective tissue disorders such as rheumatoid arthritis, systemic lupus erythematosus, and primary Sjögren's syndrome. A total of 675 references were identified, of which 118 were selected for detailed analysis and 22 were included in the final review with a total of 2338 participants. Our search focused only on studies upon connective tissue disorders such as rheumatoid arthritis, systemic lupus erythematosus, and primary Sjögren's syndrome associated with seroimmunological data. The reported prevalence of CNS involvement ranges from 9 to 92% across the reported studies. However, the association between CNS and PNS manifestations and seroimmunological profiles remains controversial. Τo date, no laboratory test has been shown as pathognomonic neither for CNS nor for PNS involvement.

Peripheral neuropathies in rheumatic diseases: More diverse and frequent than expected. A cross‐sectional study

“…In RA patients, PN secondary to entrapment occurs in 20%‐70%, sensorial PNP in 20%, and sensory‐motor PNP in 10% of cases. MNP by entrapment has been reported in 3% of patients with systemic sclerosis …”

Rheumatoid meningitis presenting with a stroke-like attack treated with recombinant tissue plasminogen activator: a case presentation

“…Rheumatoid vasculitis is one of the extra-articular complications of rheumatoid arthritis (RA). Although there are no reports of the exact incidence of central nervous system (CNS) complications of RA [ 1 ], they are considered relatively rare [ 2 ]. Among such complications, there have been extremely rare cases of sudden-onset focal brain dysfunction that resemble a stroke, which is known as rheumatoid meningitis presenting with a stroke-like attack (RMSA) [ 3 , 4 ].…”

Etiopathogenetic factors of peripheral neuropathic pain in rheumatoid arthritis

“…Интерес этой работы заключался в наличии группы контроля, состоящей из 100 здоровых, подобранных по полу и возрасту, у которых показатели ЭНМГ (скорости проведения, амплитуда) были статистически достоверно выше и соответствовали возрастной норме [16]. Большинство исследователей обращают внимание преимущественно на сенсорные полинейропатии, причем протекающие чаще субклинически [17,18].…”

“…По данным литературы [18,19], более чем у 50% пациентов с РА выявляются поражение ПНС в виде полинейропатии, у 10-70% больных -туннельные компрессии, преимущественно представленные синдромом карпального канала. Причем, согласно исследованию, опубликованному в 2012 г. в Clinical Rheumatology [5], полинейропатия характерна для пациентов с продолжительным РА, в то время как туннельные синдромы возникают преимущественно в дебюте заболевания и обусловлены локальными суставными изменениями.…”