Vasculitic neuropathy-related disability, pain, quality of life, and autonomic symptoms: a survey of 312 patients.

IF 4.4 2区 医学 Q1 RHEUMATOLOGY Rheumatology Pub Date : 2024-10-01 DOI:10.1093/rheumatology/keae038
Michael P Collins, Robert D M Hadden, Raashid A Luqmani
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Abstract

Objectives: To assess self-reported symptoms of neuropathy, disability, pain, health-related quality of life (HR-QOL) and autonomic dysfunction in patients with vasculitis.

Methods: Patients with vasculitis (with or without neuropathy) were invited by Vasculitis UK to complete an anonymous online survey.

Results: Three hundred and twelve patients (71% female) responded. Median age was 61-70 years. Median duration of vasculitis was 4 years (<2 months to >15 years). Vasculitic types included granulomatosis with polyangiitis (34%), unspecified ANCA-associated vasculitis (13%), microscopic polyangiitis (11%), eosinophilic granulomatosis with polyangiitis (11%), giant cell arteritis (10%), non-systemic vasculitic neuropathy (2%) and other (19%). Many patients reported foot/hand symptoms suggestive of neuropathy, including numbness (64%), pain (54%) or weakness (40%). Two hundred and forty-two patients (78%) met our definition of probable vasculitic neuropathy: diagnosis of neuropathy by vasculitis team OR numbness OR weakness in feet/hands. Only 52% had been formally diagnosed with neuropathy. Compared with 70 patients without neuropathy, neuropathy patients had greater disability measured by the inflammatory Rasch-built Overall Disability Scale (centile mean 63.1 [s.d. 17.3] vs 75.2 [16.7]; P < 0.0001), Inflammatory Neuropathy Cause and Treatment scale (median 2 [interquartile range 1-4] vs 0.5 [0-2]; P < 0.0001) and modified Rankin scale (median 2 [interquartile range 1-3] vs 2 [1-2)]; P = 0.0002); greater pain on an 11-point rating scale (mean 4.6 [s.d. 2.6] vs 3.5 [2.8]; P = 0.0009); and poorer HR-QOL on the EQ5D-3L (summary index mean 0.58 [s.d. 0.29] vs 0.69 [0.28]; P < 0.0001). Two-thirds reported autonomic symptoms (not associated with neuropathy).

Conclusion: Neuropathy is common and associated with significant disability, pain and impaired HR-QOL in patients with systemic vasculitis.

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血管性神经病相关的残疾、疼痛、生活质量和自主神经症状:对 312 名患者的调查。
目的评估脉管炎患者自我报告的神经病变症状、残疾、疼痛、健康相关生活质量(HR-QOL)和自主神经功能障碍:英国脉管炎协会邀请脉管炎患者(伴有或不伴有神经病变)完成匿名在线调查:结果:312 名患者(71% 为女性)做出了回应。中位年龄为 61-70 岁。血管炎病程中位数为 4 年(15 年)。血管炎类型包括肉芽肿伴多血管炎(34%)、不明ANCA相关性血管炎(13%)、显微镜下多血管炎(11%)、嗜酸性粒细胞肉芽肿伴多血管炎(11%)、巨细胞动脉炎(10%)、非系统性血管性神经病(2%)和其他(19%)。许多患者报告了提示神经病变的足部/手部症状,包括麻木(64%)、疼痛(54%)或无力(40%)。242名患者(78%)符合我们对可能患有脉管炎性神经病的定义:脉管炎小组诊断为神经病或脚/手麻木或无力。只有 52% 的患者被正式诊断为神经病变。与 70 名无神经病变的患者相比,神经病变患者的残疾程度更高,其衡量标准包括炎症性 Rasch-built 总体残疾量表(百分位数平均值 63.1 (SD 17.3) vs 75.2 (16.7);p< 0.0001)、炎症性神经病变病因和治疗量表(中位数 2 (IQR 1-4) vs 0.5(0-2);p< 0.0001)和改良Rankin量表(中位数2(IQR 1-3) vs 2 (1-2);p= 0.0002);在11点评分量表中疼痛更严重(平均4.6 (SD 2.6) vs 3.5 (2.8);p= 0.0009);在EQ5D-3L中HR-QOL更差(汇总指数平均0.58 (SD 0.29) vs 0.69 (0.28);p结论:神经病变很常见,与全身性脉管炎患者严重的残疾、疼痛和心率-QOL受损有关。
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来源期刊
Rheumatology
Rheumatology 医学-风湿病学
CiteScore
9.40
自引率
7.30%
发文量
1091
审稿时长
2 months
期刊介绍: Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.
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