痛风患者痛风压迫继发的神经病是众所周知的;然而,关于其他类型的周围神经病(PN)的数据有限。我们的目的是描述PN频率,特点,分布,模式,并通过临床评估痛风患者的相关因素,PN问卷,神经传导研究(NCS)。这项横断面描述性研究包括我们诊所的连续痛风患者(ACR/EULAR2015标准)。所有人都接受了风湿病和康复科的评估,经IRB批准。基于NCS,患者分为PN+(存在)或PN-(不存在).PN+患者被进一步分类为局部周围神经病(LPN)或全身性躯体周围神经病(GPN)。我们招募了162名患者,98%为男性(72%为痛风石)。平均年龄(SD):49.4(12)岁;平均BMI:27.9(6.0)kg/m2。合并症包括血脂异常(53%),高血压(28%),和肥胖(23.5%)。异常NCS:65%(n=106);52%LPN,48%GPN。PN+患者年龄较大,受教育程度较低,和严重的痛风。GPN患者年龄较大,受教育程度较低,与LPN或PN组相比,DN4评分更高(p=0.05);其他危险因素不显著。超过一半的痛风患者经历了神经病变,48%患有多发性单神经病或多发性神经病。这与关节损伤和功能障碍有关。机制和危险因素尚不清楚。早期识别和管理对于优化这些患者的临床结果和生活质量至关重要。关键点痛风患者的周围神经病变几乎没有报道和研究。本文报道:•痛风中的PN比以前报道的更频繁,更多样化。•单神经病是常见的,正中,但也有尺骨,腓骨和胫神经可能受伤。•Unexpected,广泛性神经病(多发性神经病和多发性单神经病)是常见的,并与严重痛风相关。•高尿酸血症/或痛风在周围神经中的直接作用需要进一步研究。
Neuropathies secondary to tophus compression in gout patients are well known; however, limited data exist on other types of peripheral neuropathies (PN). Our aim was to describe PN frequency, characteristics, distribution, patterns, and associated factors in gout patients through clinical evaluation, a PN questionnaire, and nerve conduction studies (NCS). This cross-sectional descriptive study included consecutive gout patients (ACR/EULAR 2015 criteria) from our clinic. All underwent evaluation by Rheumatology and Rehabilitation departments, with IRB approval. Based on NCS, patients were categorized as PN + (presence) or PN- (absence). PN + patients were further classified as local peripheral neuropathy (LPN) or generalized somatic peripheral neuropathy (GPN). We enrolled 162 patients, 98% male (72% tophaceous gout). Mean age (SD): 49.4 (12) years; mean BMI: 27.9 (6.0) kg/m2. Comorbidities included dyslipidemia (53%), hypertension (28%), and obesity (23.5%). Abnormal NCS: 65% (n = 106); 52% LPN, 48% GPN. PN + patients were older, had lower education, and severe tophaceous gout. GPN patients were older, had lower education, and higher DN4 scores compared to LPN or PN- groups (p = 0.05); other risk factors were not significant. Over half of gout patients experienced neuropathy, with 48% having multiplex
mononeuropathy or polyneuropathy. This was associated with joint damage and functional impairment. Mechanisms and risk factors remain unclear. Early recognition and management are crucial for optimizing clinical outcomes and quality of life in these patients. Key Points Peripheral neuropathies in gout patients had been scarcely reported and studied. This paper report that: • PN in gout is more frequent and more diverse than previously reported. • Mononeuropathies are frequent, median but also ulnar, peroneal and tibial nerves could be injured. • Unexpected, generalized neuropathies (polyneuropathy and multiplex
mononeuropathy) are frequent and associated to severe gout. • The direct role of hyperuricemia /or gout in peripheral nerves require further studies.