Peripheral Neuropathy in Chlamydia Reactive Arthritis
Keywords:joints, arthritis, chlamydia, peripheral neuropathy
Relevance. Peripheral neuropathy (PNP) in urogenital chlamydia reactive arthritis (CRA) is described as single observations, and many clinical and pathogenetic aspects of this lesion of the nervous system remain unclear. Objective of the study: to evaluate the incidence and nature of the clinical course of PNP in CRA, the connection of the nerve and joint injuries, to explore the questions of pathogenetic constructions of this neuropathy, to identify risk factors. Material and methods. We observed 101 patients with CRA, mean age of them was 32 years, disease duration — 4 years, and the male to female ratio — 1 : 1. In 90 % of CRA cases, Chlamydia trochamatis was found in prostatic secretions, in scraps from the urethra, the cervix, the vaginal wall, in 83 % — positive serologic tests for chlamydia infection. Results. Signs of PNP in CRA were in 19 % of patients in the ratio of mononeuropathy to polyneuropathy as 1 : 1, with motor, sensory and mixed disorders in a ratio of 1 : 3 : 6, the presence of autonomic changes in every second patient and more frequent distal localization of the process in the hands, which is influenced by the severity of the articular syndrome, high levels of antichlamydia antibodies in the blood, and the axonal and demyelinating indicators of electroneuromyography — by the severity of urogenital lesions and the presence of Guillain-Barre syndrome. A high rate of arthritis progression is a prognosis-negative sign of PNP course in patients with CRA. The pathogenic constructions of PNP involve the inflammatory immune proteins, disturbances of vascular endothelial function and physicochemical surface rheological properties of the serum. Conclusion. PNP takes place in every fifth patient with CRA, correlates with clinical and laboratory signs of joint disease, and in the future will be useful to identify actively this pathology of the nervous system for the subsequent timely rehabilitation, and CRA seropositivity for cyclic citrullinated peptide antibodies is a risk factor for such PNP.
Xodak LA. [Infectious polyneuropathy in children]. Aktualnaya infektologiya. 2013;1(1):114-119. Ukrainian.
Coste S, De Greslan T, Renard JL, Béquet D, Felten D. Acute polyradiculoneuropathy after Chlamydia pneumoniae infection. Revue Neurologique. 2012;158(3):361-363.
Koike H, Watanabe H, Sobue G. The spectrum of immune-mediated autonomic neuropathies: insights from the clinicopathological features. Journal of neurology, neurosurgery, and psychiatry. 2013;84(1):98-106. DOI: 10.1136/jnnp-2012-302833.
Mattson MP. Infectious agents and age-related neurodegenerative disorders. Ageing Research Reviews. 2014;3(1):105-20. DOI: 10.1146/annurev-neuro-071714-033828.
Mulhearn B, Bruce IN. Indications for IVIG in rheumatic diseases. Rheumatology. 2015;54(3):383-91. DOI: 10.1093/rheumatology/keu429.
Naito M, Nakamura I, Ito K. Simultaneous bilateral posterior interosseous nerve palsy caused by rheumatoid synovitis of the elbows. Modern Rheumatology. 2014;24(6):1005-10. DOI: 10.3109/14397595.2013.874747.
Nouh A, Carbunar O, Ruland S. Neurology of rheumatologic disorders. Current Neurology and Neuroscience Reports. 2014;14(7):456-66. doi: 10.1007/s11910-014-0456-6.
Oomatia A, Fang H, Petri M, Birnbaum J. Peripheral neuropathies in systemic lupus erythematosus: clinical features, disease associations, and immunologic characteristics evaluated over a twenty-five-year study period. Arthritis & Rheumatology. 2014;66(4):1000-9. DOI: 10.1002/art.38302.
Ozkul A, Yılmaz A, Akyol A, Kiylioglu N. Cerebral vasculitis as a major manifestation of rheumatoid arthritis. Acta Clinica Belgica. 2015;70(5):359-63. DOI: 10.1080/17843286.2015.1131965.
Punter MN, Varma AR. Myeloradiculitis with meningoencephalopathy and optic neuritis in a case of previous Chlamydia psittaci infection. BMJ Case Reports. 2010;13(12):152-7. DOI: 10.1136/bcr.12.2009.2521.
Schessl J, Luther B, Kirschner J, Mauff G, Korinthenberg R. Infections and vaccinations preceding childhood Guillain-Barré syndrome: a prospective study. European Journal of Pediatrics. 2016;165(9):605-12.
Sim MK, Kim DY, Yoon J, Park DH, Kim YG. Assessment of peripheral neuropathy in patients with rheumatoid arthritis who complain of neurologic symptoms. Annals of Rehabilitation Medicine. 2014;38(2):249-55. DOI: 10.5535/arm.2014.38.2.249.
Sonnino S, Chiricozzi E, Ciampa MG, Mauri L, Prinetti A, Toffano G, Aureli M. Serum antibodies to glycans in peripheral neuropathies. Molecular Neurobiology. 2016;11(2):183-9.
Syngle A, Verma I, Krishan P, Garg N, Syngle V. Disease-modifying anti-rheumatic drugs improve autonomic neuropathy in arthritis: DIANA study. Clinical Rheumatology. 2015;34(7):1233-41. DOI: 10.1007/s10067-014-2716-x.
Ubogu EE. Inflammatory neuropathies: pathology, molecular markers and targets for specific therapeutic intervention. Acta Neuropathologica. 2015;130(4):445-68. DOI: 10.1007/s00401-015-1466-4.
Zhang DQ, Wang R, Li T, Zhou JP, Chang GQ, Zhao N, Yang LN, Zhai H, Yang L. Reduced soluble RAGE is associated with disease severity of axonal Guillain-Barré syndrome. Scientific Reports. 2016;23(6):21890. DOI: 10.1038/srep21890.
Copyright (c) 2016 ACTUAL INFECTOLOGY
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.