Year: 2026 | Month: October | Volume: 16 | Issue: 10 | Pages: 84-92
DOI: https://doi.org/10.52403/ijhsr.20261010
Prevalence, Pattern and Clinical Correlates of Peripheral Neuropathy in Rheumatoid Arthritis: A Cross-Sectional Nerve Conduction Study
S. Ashok Kumar1, M. C. Lalith Raja Deepak2, R. Elanchezian3
1Assistant Professor, Department of Medicine, Government Kilpauk Medical College, Chennai – 600010, Tamil Nadu, India.
2Assistant Professor, Department of Medicine, Government Kilpauk Medical College, Chennai – 600010, Tamil Nadu, India.
3Assistant Professor, Department of Medicine, Government Chengalpattu Medical College, Chengalpattu – 603001, Tamil Nadu, India.
Corresponding Author: Dr. R. Elanchezian
ABSTRACT
Background: Rheumatoid arthritis (RA) is a chronic immune-inflammatory systemic disease that, besides synovial joints, can affect the peripheral nervous system. Peripheral neuropathy in RA is frequently under-recognised clinically because neuropathic symptoms are often attributed to joint disease, and neurological examination can be difficult in patients with severe articular involvement.
Objective: To study the prevalence and pattern of peripheral neuropathy in patients with RA using nerve conduction studies (NCS), and to examine its association with disease parameters and other clinical and laboratory variables.
Materials and Methods: This cross-sectional study was conducted over eight months in the Department of Medicine and Rheumatology, Government Kilpauk Medical College, Chennai, among 60 consecutive patients diagnosed with RA by the 1987 revised ACR classification criteria. All patients underwent clinical evaluation, relevant laboratory investigations and bilateral NCS of the median, ulnar, common peroneal, posterior tibial and sural nerves. Polyneuropathy was diagnosed when at least three abnormal NCS parameters were present. Associations were assessed using Fisher's exact test and the unpaired t-test, with multivariate logistic regression used to examine independent associations; a two-tailed p value <0.05 was considered significant.
Results: Peripheral neuropathy was present in 26 of 60 patients (43.3%). The commonest pattern was sensorimotor neuropathy (42.3%), followed by sensory neuropathy (23.1%), motor neuropathy (19.2%), carpal tunnel syndrome (7.7%) and mononeuritis multiplex (7.7%). Patients with neuropathy were significantly older (mean 45.85 vs 36.65 years, p<0.0001), had higher ESR (mean 39.77 vs 28.97 mm/hr, p=0.0007), longer RA duration (mean 8.23 vs 5.06 years, p=0.0004), and higher rheumatoid factor (96.2% vs 67.6%, p=0.0064) and anti-CCP antibody positivity (30.8% vs 8.8%, p=0.0288) than those without neuropathy. On multivariate logistic regression, age >40 years, ESR >40 mm/hr, anti-CCP antibody positivity and RA duration >10 years remained independently associated with peripheral neuropathy. Gender, haemoglobin, complete blood counts, CRP, steroid use and neuropathic symptom reporting showed no significant association.
Conclusion: Peripheral neuropathy, often subclinical, is common in patients with RA and is associated with older age, higher ESR, longer disease duration and anti-CCP antibody positivity. Nerve conduction studies may be a useful tool for detecting subclinical neuropathy in RA patients with these risk factors, particularly as subjective neuropathic symptoms correlate poorly with electrophysiological findings in this population.
Key words: Rheumatoid arthritis; Peripheral neuropathy; Nerve conduction study; Anti-cyclic citrullinated peptide antibody; Cross-sectional study.