Rheumatoid Arthritis

Inflammatory Disease ◽

Neurologic Complications ◽

Neurological Sequelae ◽

Systemic Inflammatory Disease

Rheumatoid arthritis (RA) is a systemic inflammatory disease that is characterized principally by a polyarthritis, but can result in several neurologic complications involving both the central and peripheral nervous system. In addition, several immunotherapies used to treat RA have been associated with neurological complications. In this chapter, we review the characteristic neurological sequelae of RA as well as the possible neurological consequences of its therapeutic regimens.

Polyneuropathy following COVID-19 infection: the rehabilitation approach

BMJ Case Reports ◽

10.1136/bcr-2021-242330 ◽

2021 ◽

Vol 14 (5) ◽

pp. e242330

Author(s):

Ahmad Saif ◽

Anton Pick

Keyword(s):

Nervous System ◽

Critical Illness ◽

Upper Limb ◽

Inflammatory Disease ◽

Pathological Process ◽

Neurological Manifestations ◽

Sensorimotor Polyneuropathy ◽

System Disease ◽

Symmetrical Pattern

A range of neurological manifestations associated with COVID-19 have been reported in the literature, but the pathogenesis of these have yet to be fully explained. The majority of cases of peripheral nervous system disease published thus far have shown a symmetrical pattern. In contrast, we describe the case of a patient with asymmetrical predominantly upper-limb sensorimotor polyneuropathy following COVID-19 infection, likely due to a multifactorial pathological process involving critical illness neuropathy, mechanical injury and inflammatory disease. His presentation, management and recovery contribute to the understanding of this complex condition and informs rehabilitation approaches.

The Other Side of SARS-CoV-2 Infection: Neurological Sequelae in Patients

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.632673 ◽

2021 ◽

Vol 13 ◽

Author(s):

Isabel M. Alonso-Bellido ◽

Sara Bachiller ◽

Guillermo Vázquez ◽

Luis Cruz-Hernández ◽

Emilio Martínez ◽

...

Keyword(s):

Nervous System ◽

Distress Syndrome ◽

Immune Reaction ◽

Cerebrovascular Disorders ◽

Review Article ◽

Neurological Sequelae ◽

Long Term Consequences ◽

Taste And Smell

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread around the globe causing coronavirus disease 2019 (COVID-19). Because it affects the respiratory system, common symptoms are cough and breathing difficulties with fever and fatigue. Also, some cases progress to acute respiratory distress syndrome (ARDS). The acute phase of COVID-19 has been also related to nervous system symptoms, including loss of taste and smell as well as encephalitis and cerebrovascular disorders. However, it remains unclear if neurological complications are due to the direct viral infection of the nervous system, or they appear as a consequence of the immune reaction against the virus in patients who presented pre-existing deficits or had a certain detrimental immune response. Importantly, the medium and long-term consequences of the infection by SARS-CoV-2 in the nervous system remain at present unknown. This review article aims to give an overview of the current neurological symptoms associated with COVID-19, as well as attempting to provide an insight beyond the acute affectation.

Nervous system

Oxford Textbook of Rheumatology ◽

10.1093/med/9780199642489.003.0018_update_002 ◽

2013 ◽

pp. 140-145

Author(s):

Andrew Graham ◽

Clare Galton

Keyword(s):

Nervous System ◽

Lupus Erythematosus ◽

Transverse Myelitis ◽

Neurological Involvement ◽

Disease Modifying Therapy ◽

Entrapment Neuropathies ◽

System P ◽

Tunnel Syndrome

Rheumatological conditions may be complicated by a variety of both central and peripheral nervous system disorders. Common complications such as entrapment neuropathies are familiar to rheumatologists but accurate diagnosis of less common neurological disorders may be challenging; careful clinical reasoning is essential, supplemented where necessary by imaging, neurophysiology, and other special investigations including cerebrospinal fluid examination. Complications vary according to the nature of the background condition. In rheumatoid arthritis, neurological involvement is typically related to the mechanical consequences of advancing disease; most commonly, entrapment neuropathies such as carpal tunnel syndrome and cervical myelopathy due to atlantoaxial subluxation. By contrast, neurological involvement in systemic lupus erythematosus (SLE) tends to occur earlier in the disease course, with a much wider range of manifestations. The management of stroke or seizures in SLE is not necessarily any different from that in the general population, unless complicated by the antiphospholipid syndrome. However, less common neurological syndromes may demand more specific investigation and treatment. For example, longitudinally extensive transverse myelitis and recurrent optic neuritis (neuromyelitis optica, or Devic’s disease) is frequently associated with antibodies to aquaporin-4, and is highly likely to relapse unless treated vigorously with humoral immunosuppression. Nervous system involvement in vasculitis is common. Finally, not all neurological disorder in rheumatological disease is necessarily due to the underlying condition; neurological complications of disease-modifying therapy are increasingly recognized, in particular central and peripheral nervous system demyelination associated with TNF-α‎‎ inhibitors.

RHEUMATOID ARTHRITIS IN NON-CAUCASIAN POPULATION: EPIDEMIOLOGICAL DATA

Romanian Journal of Rheumatology ◽

10.37897/rjr.2015.3.3 ◽

2015 ◽

Vol 24 (3) ◽

pp. 141-144

Author(s):

Cristina Suta ◽

◽

Maria Suta ◽

Elvira Craiu ◽

◽

...

Keyword(s):

Rheumatoid Arthritis ◽

American Indian ◽

Environmental Exposure ◽

Inflammatory Disease ◽

Regional Variation ◽

Epidemiological Data ◽

Caucasian Population ◽

Susceptible Individual ◽

Systemic Inflammatory Disease ◽

Indian Tribes

Rheumatoid arthritis (RA) is a common autoimmune systemic inflammatory disease with still unknown cause. A robust hypothesis for the occurence of the disease is the result of an environmental exposure in a genetically susceptible individual. The risk of RA varies by ethnicity: the majority of the Caucasian populations reported a prevalence of 0.5 to 1% for this disease; higher prevalences were observed in American Indian tribes and lower ones, in countries of Africa and Asia. This regional variation in the prevalence of RA sustains the involvement of both genetic and enviromental factors in the occurence of this condition.

Nervous system

10.1093/med/9780199642489.003.0018 ◽

2013 ◽

Author(s):

Andrew Graham ◽

Clare Galton

Keyword(s):

Nervous System ◽

Lupus Erythematosus ◽

Transverse Myelitis ◽

Neurological Involvement ◽

Disease Modifying Therapy ◽

Entrapment Neuropathies ◽

System P ◽

System Disorder

Rheumatological conditions may be complicated by a variety of both central and peripheral nervous system disorder. Common complications such as entrapment neuropathies are familiar to rheumatologists but accurate diagnosis of less common neurological disorders may be challenging; careful clinical reasoning is essential, supplemented where necessary by imaging, neurophysiology, and other special investigations including cerebrospinal fluid examination. Complications vary according to the nature of background condition. In rheumatoid arthritis, neurological involvement is typically related to the mechanical consequences of advancing disease; the commonest complications are carpal tunnel syndrome and cervical myelopathy due to atlantoaxial subluxation. By contrast, neurological involvement in systemic lupus erythematosus (SLE) tends to occur earlier in the disease course, with a much wider range of manifestations. The management of stroke or seizures in SLE is not necessarily any different from that in the general population, unless complicated by the antiphospholipid syndrome. However, less common neurological syndromes may demand more specific investigation and treatment. For example, longitudinally extensive transverse myelitis and recurrent optic neuritis (neuromyelitis optica, or Devic's disease) is frequently associated with antibodies to aquaporin-4, and is highly likely to relapse unless treated vigorously with humoral immunosuppression. Nervous system involvement in vasculitis is common. Finally, not all neurological disorder in rheumatological disease is necessarily due to the underlying condition; neurological complications of disease-modifying therapy are increasingly recognized, in particular central and peripheral nervous system demyelination associated with TNF-α‎ inhibitors.

COVID-19 Infection and Neurological Complications: Present Findings and Future Predictions

Neuroepidemiology ◽

10.1159/000508991 ◽

2020 ◽

Vol 54 (5) ◽

pp. 364-369 ◽

Cited By ~ 5

Author(s):

Ettore Beghi ◽

Valery Feigin ◽

Valeria Caso ◽

Paola Santalucia ◽

Giancarlo Logroscino

Keyword(s):

Nervous System ◽

Viral Infections ◽

Neurological Diseases ◽

Influenza Viruses ◽

Surveillance Systems ◽

Care Needs ◽

The Past ◽

Immune Mediated

The present outbreak caused by SARS-CoV-2, an influenza virus with neurotropic potential, presents with neurological manifestations in a large proportion of the affected individuals. Disorders of the central and peripheral nervous system are all present, while stroke, ataxia, seizures, and depressed level of consciousness are more common in severely affected patients. People with these severe complications are most likely elderly with medical comorbidities, especially hypertension and other vascular risk factors. However, postinfectious complications are also expected. Neurological disorders as sequelae of influenza viruses have been repeatedly documented in the past and include symptoms, signs, and diseases occurring during the acute phase and, not rarely, during follow-up. Postinfectious neurological complications are the result of the activation of immune mechanisms and can explain the insurgence of immune-mediated diseases, including the Guillain-Barré syndrome and other diseases of the central and peripheral nervous system that in the past occurred as complications of viral infections and occasionally with vaccines. For these reasons, the present outbreak calls for the introduction of surveillance systems to monitor changes in the frequency of several immune-mediated neurological diseases. These changes will determine a reorganization of the measures apt to describe the interaction between the virus, the environment, and the host in areas of different dimensions, from local communities to regions with several millions of inhabitants. The public health system, mainly primary care, needs to be strengthened to ensure that research and development efforts are directed toward right needs and directions. To cope with the present pandemic, better collaboration is required between international organizations along with more research funding, and tools in order to detect, treat, and prevent future epidemics.

Varicella-Zoster Virus Infections of the Nervous System

Archives of Pathology & Laboratory Medicine ◽

10.5858/2001-125-0770-vzviot ◽

2001 ◽

Vol 125 (6) ◽

pp. 770-780 ◽

Cited By ~ 9

Author(s):

B. K. Kleinschmidt-DeMasters ◽

Donald H. Gilden

Keyword(s):

Nervous System ◽

Varicella Zoster Virus ◽

Cerebral Arteries ◽

Infectious Agent ◽

Spinal Ganglia ◽

Ependymal Cells ◽

Pcr Analysis ◽

Neurologic Complications ◽

Varicella Zoster

Abstract Background.—Diseases that present with protean manifestations are the diseases most likely to pose diagnostic challenges for both clinicians and pathologists. Among the most diverse disorders caused by a single known toxic, metabolic, neoplastic, or infectious agent are the central and peripheral nervous system complications of varicella-zoster virus (VZV). Methods.—The pathologic correlates of the neurologic complications of VZV infection, as well as current methods for detecting viral infections, are discussed and presented in pictorial format for the practicing pathologist. Results.—Varicella-zoster virus causes chickenpox (varicella), usually in childhood; most children manifest only mild neurologic sequelae. After chickenpox resolves, the virus becomes latent in neurons of cranial and spinal ganglia of nearly all individuals. In elderly and immunocompromised individuals, the virus may reactivate to produce shingles (zoster). After zoster resolves, many elderly patients experience postherpetic neuralgia. Uncommonly, VZV can spread to large cerebral arteries to cause a spectrum of large-vessel vascular damage, ranging from vasculopathy to vasculitis, with stroke. In immunocompromised individuals, especially those with cancer or acquired immunodeficiency syndrome, deeper tissue penetration of the virus may occur (as compared with immunocompetent individuals), with resultant myelitis, small-vessel vasculopathy, ventriculitis, and meningoencephalitis. Detection of the virus in neurons, oligodendrocytes, meningeal cells, ependymal cells, or the blood vessel wall often requires a combination of morphologic, immunohistochemical, in situ hybridization, and polymerase chain reaction (PCR) methods. The PCR analysis of cerebrospinal fluid remains the mainstay for diagnosing the neurologic complications of VZV during life. Conclusions.—Varicella-zoster virus infects a wide variety of cell types in the central and peripheral nervous system, explaining the diversity of clinical disorders associated with the virus.

Vasculitis

Mayo Clinic Internal Medicine Board Review ◽

10.1093/med/9780190464868.003.0081 ◽

2016 ◽

pp. 839-848

Author(s):

Matthew J. Koster ◽

Kenneth J. Warrington

Keyword(s):

Rheumatoid Arthritis ◽

Inflammatory Bowel Disease ◽

Psoriatic Arthritis ◽

Ankylosing Spondylitis ◽

Inflammatory Disease ◽

Joint Destruction ◽

Age Related ◽

Systemic Inflammatory Disease ◽

Inflammatory Bowel ◽

Reiter Syndrome

Rheumatoid arthritis is a chronic systemic inflammatory disease characterized by joint destruction. It affects 0.03% to 1.5% of the population worldwide. Women are affected 3 times more frequently than men. Its incidence peaks between the ages of 35 and 45 years; however, the age-related prevalence of the disease increases even after age 65 years. Conditions in the spondyloarthritis spectrum include ankylosing spondylitis, reactive arthritis (Reiter syndrome), arthritis related to inflammatory bowel disease, and psoriatic arthritis.