Clinical Manifestations of Mononeuritis Multiplex in Patients with Rheumatoid Arthritis / 대한류마티스학회지

ABSTRACT

OBJECTIVE: Mononeuritis multiplex is an extra-articular manifestation associated with rheumatoid arthritis. This study set out to investigate its clinical characteristics in Korea. MEHTODS Clinical characteristics and laboratory data were compared retrospectively by review of medical records between 12 patients with mononeuritis multiplex (case) and randomly selected 116 age-matched patients without mononeuritis multiplex in patients with rheumatoid arthritis (control). RESULTS: Mean age of the case group was 51.8+/-8.4 years old with 7 males and 5 females which showed higher prevalence of male gender compared to the control group (p<0.05). There was no difference in mean duration of disease between two groups. Upper limbs, lower limbs and both upper and lower limbs were involved in 3, 7 and 2 patients, respectively. Major symptoms were tingling (66.6%), paresthesia (33.3%), pain (33.3%), foot drop (33.3%), or muscle weakness (16.7%). Skin ulceration was accompanied in 3 patients, but vasculitis of other organs was not found. Mean C-reactive protein level in the case group was 7.6+/-6.7 mg/dL, which was higher compared to 2.4+/-3.1 mg/dL in the control group (p<0.05). Rheumatoid factor was positive in 83.3% of the case, however positive rate and titer showed no significant difference with the control group. There was no difference in other extra-articular manifestations between two groups. Six patients were treated with glucocorticoid and immuno-suppressants and 6 patients with only glucocorticoid1 for 6.8+/-7.1 weeks. Symptoms improved after treatment in 10 patients but, it lasted in 2 patients. CONCLUSION: Rheumatoid arthritis associated mononeuritis multiplex was more prevalent in males with higher CRP levels, and responded well to medical intervention including glucocorticoid, and immunosuppressants.