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Aktuelle Neurologie 2015; 42(04): 212-217
DOI: 10.1055/s-0035-1548821
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Rheumatologisch bedingte neurologische Erkrankungen

Neurological Disorders in Rheumatology
M. Maschke
1   Klinik für Neurologie, Krankenhaus der Barmherzigen Brüder, Trier
,
S. M. Weiner
2   Klinik Innere Medizin 2, Krankenhaus der Barmherzigen Brüder, Trier
› Author Affiliations
Further Information

Publication History

Publication Date:
14 April 2015 (online)

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Zusammenfassung

Rheumatologische Erkrankungen gehören zu den weltweit häufigsten Ursachen für eine krankheitsbedingte signifikante Einschränkung der Lebensqualität und Lebenserwartung und verursachen signifikante volkswirtschaftliche Kosten. Gerade bei der rheumatoiden Arthritis, beim systemischen Lupus erythematodes, beim Sjögren-Syndrom und der ankylosierenden Spondylitis sind neurologische Begleiterkrankungen sehr häufig. Dabei sind alle Bereiche vom ZNS über das periphere Nervensystem bis hin zur Muskulatur betroffen. Am häufigsten sind sicherlich neben einer krankheitsbegleitenden Depression Polyneuropathien in sehr unterschiedlicher Ausprägung. Subklinisch sind nach Studien z. B. bis zu 85% der Patienten mit einer rheumatoiden Arthritis von einer PNP betroffen. Darüber hinaus können in der Therapie rheumatologischer Erkrankungen verwandte Medikamente wie vor allem monoklonale Antikörper zu neurologischen Nebenwirkungen inklusive der Entwicklung einer progressiven multifokalen Leukoenzephalopathie führen. Vor diesem Hintergrund ist es wichtig, rheumatologische Erkrankungen in die Differenzialdiagnose bei neu aufgetretenen neurologischen Erkrankungen einzubeziehen.

Abstract

Rheumatological disorders are amongst the most frequent diseases worldwide leading to significant disability, loss of quality of life, increased mortality and are accompanied by high social costs. In particular, rheumatoid arthritis, sytemic lupus erythematodes and Sjögren syndrome as well as ankylosing spondylitis frequently result in neurological diseases. All parts of the nervous system and the muscles may be involved. Following depressive disorders, most frequently are peripheral neuropathies of various types. Studies have revealed that around 85% of all patients with rheumatoid arthritis are subclinically affected by neuropathies. In addition, antirheumatoid medications such as monoclonal antibodies may result in neurological side effects including progressive multifocal leukoencephalopathy. Against this background, it is important to include rheumatological disorders in the differential diagnosis and work-up of neurological diseases.

Schlüsselwörter

Rheumatoide Arthritis - Lupus erythematodes - Sjögren-Syndrom - Ankylosierende Spondylitis

Keywords

rheumatoid arthritis - lupus erythematodes - sjögren syndrome - ankylosing spondylitis
 

  • Literatur

  • 1 Badley EM. Rheumatic diseases: the unnoticed elephant in the room. J Rheumatol 2008; 35: 6-7
    PubMedGoogle Scholar
  • 2 Lee DM, Weinblatt ME. Rheumatoid arthritis. Lancet 2001; 358: 903-911
    CrossrefPubMedGoogle Scholar
  • 3 Feldmann M, Maini RN. Anti-TNF therapy, from rationale to standard of care: what lessons has it taught us?. J Immunol 2010; 185: 791-794
    CrossrefPubMedGoogle Scholar
  • 4 Fuggle NR, Howe FA, Allen RL et al. New insights into the impact of neuro-inflammation in rheumatoid arthritis. Front Neurosci 2014; 8: 357 eCollection 2014
    PubMedGoogle Scholar
  • 5 Ramos-Remus C, Duran-Barragan S, Castillo-Ortiz JD. Beyond the joints: neurological involvement in rheumatoid arthritis. Clin Rheumatol 2012; 31: 1-12
    CrossrefPubMedGoogle Scholar
  • 6 Hanly JG, Fisk JD, McCurdy G et al. Neuropsychiatric syndromes in patients with systemic lupus erythematosus and rheumatoid arthritis. J Rheumatol 2005; 32: 1459-1456
    PubMedGoogle Scholar
  • 7 McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med 2011; 365: 2205-2219
    CrossrefPubMedGoogle Scholar
  • 8 Suwannalai 1 P, Trouw LA, Toes RE et al. Anti-citrullinated protein antibodies (ACPA) in early rheumatoid arthritis. Mod Rheumatol 2012; 22: 15-20
    CrossrefPubMedGoogle Scholar
  • 9 Furst DE, Emery P. Rheumatoid arthritis pathophysiology: update on emerging cytokine and cytokine-associated cell targets. Rheumatology (Oxford) 2014; 53: 1560-1569
    CrossrefPubMedGoogle Scholar
  • 10 Aletaha D, Neogi T, Silman AJ et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against rheumatism collaborative initiative. Arthritis Rheum 2010; 62: 2569-2581
    Google Scholar
  • 11 Albrecht K, Krüger K, Wollenhaupt J et al. German Society of Rheumatology. German guidelines for the sequential medical treatment of rheumatoid arthritis with traditional and biologic disease-modifying antirheumatic drugs. Rheumatol Int 2014; 34: 1-9
    CrossrefPubMedGoogle Scholar
  • 12 Smolen 1 JS, Landewé R, Breedveld FC et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis 2014; 73: 492-509
    PubMedGoogle Scholar
  • 13 Tak PP, Kalden JR. Advances in rheumatology: new targeted therapeutics. Arthritis Res Ther 2011; 13 (Suppl 1): S5
    PubMedGoogle Scholar
  • 14 Selmi C, Generali E, Massarotti M et al. New treatments for inflammatory rheumatic disease. Immunol Res 2014; 60: 277-288
    CrossrefPubMedGoogle Scholar
  • 15 Hamed SA, Selim ZI, Elattar AM et al. Assessment of biocorrelates for brain involvement in female patients with rheumatoid arthritis. Clin Rheumatol 2012; 31: 123-132
    CrossrefPubMedGoogle Scholar
  • 16 Matcham 1 F, Rayner L, Steer S et al. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford) 2013; 52: 2136-2148
    CrossrefPubMedGoogle Scholar
  • 17 Brüggemann N, Gottschalk S, Holl-Ulrich K et al. Cranial pachymeningitis: a rare neurological syndrome with heterogeneous aetiology. J Neurol Neurosurg Psychiatry 2010; 81: 294-298
    CrossrefPubMedGoogle Scholar
  • 18 Chowdhry V, Kumar N, Lachance DH et al. An unusual presentation of rheumatoid meningitis. J Neuroimaging 2005; 15: 286-288
    CrossrefPubMedGoogle Scholar
  • 19 Kurne A, Karabudak R, Karadag O et al. An unusual central nervous system involvement in rheumatoid arthritis: combination of pachymeningitis and cerebral vasculitis. Rheumatol Int. 2009; 29: 1349-1353
    CrossrefPubMedGoogle Scholar
  • 20 Cianfoni A, Falcone C, Faustini F et al. Rheumatoid leptomeningitis: magnetic resonance imaging and pathologic findings – a case report. J Neuroimaging 2010; 20: 192-194
    CrossrefPubMedGoogle Scholar
  • 21 Agarwal V, Singh R Wiclaf et al. A clinical, electrophysiological, and pathological study of neuropathy in rheumatoid arthritis. Clin Rheumatol 2008; 27: 841-844
    CrossrefPubMedGoogle Scholar
  • 22 Steinber VL. Neuropathy in rheumatoid disease. Br Med J 1960; 1: 1600-1603
    CrossrefPubMedGoogle Scholar
  • 23 Weller RO, Bruckner FE, Chamberlain MA. Rheumatoid neuropathy: a histological and electrophysiological study. J Neurol Neurosurg Psychiatry 1970; 33: 592-604
    CrossrefPubMedGoogle Scholar
  • 24 Pallis CA, Scott JT. Peripheral neuropathy in rheumatoid arthritis. Br Med J 1965; 1: 1141-1147
    CrossrefPubMedGoogle Scholar
  • 25 Chamberlain MA, Bruckner FE. Rheumatoid neuropathy. Clinical and electrophysiological features. Ann Rheum Dis 1970; 29: 609-616
    CrossrefPubMedGoogle Scholar
  • 26 Lanzillo B, Pappone N, Crisci C et al. Subclinical peripheral nerve involvement in patients with rheumatoid arthritis. Arthritis Rheum 1998; 41: 1196-1202
    CrossrefPubMedGoogle Scholar
  • 27 Ahmed Z, Powell R, Llewelyn G et al. Chronic inflammatory demyelinating polyradiculoneuropathy complicating anti TNF α therapy for chronic plaque psoriasis. BMJ Case Rep 2011; pii: bcr0820114674
    PubMedGoogle Scholar
  • 28 Alshekhlee A, Basiri K, Miles JD et al. Chronic inflammatory demyelinating polyneuropathy associated with tumor necrosis factor-alpha antagonists. Muscle Nerve 2010; 41: 723-727
    CrossrefPubMedGoogle Scholar
  • 29 Naranjo A, Carmona L, Gavrila D et al EMECAR Study Group . Prevalence and associated factors of anterior atlantoaxial luxation in a nation-wide sample of rheumatoid arthritis patients. Clin Exp Rheumatol 2004; 22: 427-432
    PubMedGoogle Scholar
  • 30 Watson P, Fekete J, Deck J. Central nervous system vasculitis in rheumatoid arthritis. Can J Neurol Sci 1977; 4: 269-272
    PubMedGoogle Scholar
  • 31 Neamtu 1 L, Belmont M, Miller DC et al. Rheumatoid disease of the CNS with meningeal vasculitis presenting with a seizure. Neurology 2001; 56: 814-815
    PubMedGoogle Scholar
  • 32 Lee YC, Nassikas NJ, Clauw DJ. The role of the central nervous system in the generation and maintenance of chronic pain in rheumatoid arthritis, osteoarthritis and fibromyalgia. Arthritis Res Ther 2011; 13: 211
    CrossrefPubMedGoogle Scholar
  • 33 Schweinhardt P, Kalk N, Wartolowska K et al. Investigation into the neural correlates of emotional augmentation of clinical pain. Neuroimage 2008; 40: 759-766
    CrossrefPubMedGoogle Scholar
  • 34 Wendler J, Hummel T, Reissinger M et al. Patients with rheumatoid arthritis adapt differently to repetitive painful stimuli compared to healthy controls. J Clin Neurosci 2001; 8: 272-277
    CrossrefPubMedGoogle Scholar
  • 35 Poddubnyy D, Rudwaleit M, Sieper J. Frühe Spondylarthritiden. Z Rheumatol 2012; 71: 19-26
    CrossrefPubMedGoogle Scholar
  • 36 Raychaudhuri SP, Deodhar A. The classification and diagnostic criteria of ankylosing spondylitis. J Autoimmun 2014; 48-49: 128-133
    CrossrefPubMedGoogle Scholar
  • 37 Rudwaleit M, Feldtkeller E, Sieper J. Easy assessment of axial spondyloarthritis (early ankylosing spondylitis) at the bedside. Ann Rheum Dis 2006; 65: 1251-1252
    CrossrefPubMedGoogle Scholar
  • 38 Navarro-Sarabia F, Fernández-Sueiro JL, Torre-Alonso JC et al. High-dose etanercept in ankylosing spondylitis: results of a 12-week randomized, double blind, controlled multicentre study (LOADET study). Rheumatology (Oxford) 2011; 50: 1828-1837
    CrossrefPubMedGoogle Scholar
  • 39 Li ZH, Zhang Y, Wang J et al. Etanercept in the treatment of ankylosing spondylitis: a meta-analysis of randomized, double-blind, placebo-controlled clinical trials, and the comparison of the Caucasian and Chinese population. Eur J Orthop Surg Traumatol 2013; 23: 497-506
    CrossrefPubMedGoogle Scholar
  • 40 Knockaert DC, Malysse IG, Peetermans WE. Ankylosing spondylitis. An unusual manifestation of familial Mediterranean fever. Report of a case complicated by amyloidosis and polyneuropathy. Clin Rheumatol 1989; 8: 408-412
    CrossrefPubMedGoogle Scholar
  • 41 Tekatas A, Pamuk ON. Increased frequency of restless leg syndrome in patients with ankylosing spondylitis. Int J Rheum Dis (in press)
    PubMedGoogle Scholar
  • 42 Ahn NU, Ahn UM, Nallamshetty L et al. Cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome): meta-analysis of outcomes after medical and surgical treatments. J Spinal Disord 2001; 14: 427-433
    CrossrefPubMedGoogle Scholar
  • 43 Chou YS, Lu DW, Chen JT. Ankylosing spondylitis presented as unilateral optic neuritis in a young woman. Ocul Immunol Inflamm 2011; 19: 115-117
    CrossrefPubMedGoogle Scholar
  • 44 Appenzeller S, Werner de Castro GR, Sampaio-Barros PD et al. Differential diagnosis of optic neuritis in a patient with ankylosing spondylitis. Rheumatol Int 2004; 24: 247-249
    PubMedGoogle Scholar
  • 45 Menon V, Khokhar S. Ankylosing spondylitis in a case of recurrent optic neuritis. J Neuroophthalmol 2001; 21: 235
    CrossrefPubMedGoogle Scholar
  • 46 Helmick CG, Felson DT, Lawrence RC et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part I. Arthritis Rheum 2008; 58: 15-25
    CrossrefPubMedGoogle Scholar
  • 47 Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40: 1725
    PubMedGoogle Scholar
  • 48 Petri M, Orbai AM, Alarcón GS et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012; 64: 2677-2686
    CrossrefPubMedGoogle Scholar
  • 49 The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum 1999; 42: 599-608
    CrossrefPubMedGoogle Scholar
  • 50 Borowoy AM, Pope JE, Silverman E et al. Neuropsychiatric lupus: the prevalence and autoantibody associations depend on the definition: results from the 1000 faces of lupus cohort. Semin Arthritis Rheum 2012; 42: 179-185
    CrossrefPubMedGoogle Scholar
  • 51 Jeltsch-David H, Muller S. Neuropsychiatric systemic lupus erythematosus: pathogenesis and biomarkers. Nat Rev Neurol 2014; 10: 579-596
    CrossrefPubMedGoogle Scholar
  • 52 Lauvsnes MB, Omdal R. Systemic lupus erythematosus, the brain and anti-NR2 antibodies. J Neurol 2012; 259: 622-629
    CrossrefPubMedGoogle Scholar
  • 53 Hanly JG, Robichaud J, Fisk JD. Anti-NR2 glutamate receptor antibodies and cognitive function in systemic lupus erythematosus. J Rheumatol 2006; 33: 1553-1558
    PubMedGoogle Scholar
  • 54 van Exel E, Jacobs J, Korswagen LA et al. Depression in systemic lupus erythematosus, dependent on or independent of severity of disease. Lupus 2013; 22: 1462-1469
    CrossrefPubMedGoogle Scholar
  • 55 Schmeding A, Schneider M. Fatigue, health-related quality of life and other patient-reported outcomes in systemic lupus erythematosus. Best Pract Res Clin Rheumatol 2013; 27: 363-375
    CrossrefPubMedGoogle Scholar
  • 56 Katsiari CG, Vikelis M, Paraskevopoulou ES et al. Headache in systemic lupus erythematosus vs multiple sclerosis: a prospective comparative study. Headache 2011; 51: 1398-1407
    CrossrefPubMedGoogle Scholar
  • 57 Saison J, Costedoat-Chalumeau N, Maucort-Boulch D et al. Systemic lupus erythematosus-associated acute transverse myelitis: manifestations, treatments, outcomes, and prognostic factors in 20 patients. Lupus 2015; 24: 74-81
    CrossrefPubMedGoogle Scholar
  • 58 Hanly JG. Diagnosis and management of neuropsychiatric SLE. Nat Rev Rheumatol 2014; 10: 338-347
    CrossrefPubMedGoogle Scholar
  • 59 Cobo-Ibáñez T, Loza-Santamaría E, Pego-Reigosa JM et al. Efficacy and safety of rituximab in the treatment of non-renal systemic lupus erythematosus: A systematic review. Semin Arthritis Rheum 2014; 44: 175-185
    CrossrefPubMedGoogle Scholar
  • 60 Fox RI, Stern M, Michelson P. Update in Sjögren syndrome. Curr Opin Rheumatol 2000; 12: 391-398
    CrossrefPubMedGoogle Scholar
  • 61 Vitali C, Bombardieri S, Jonsson R et al. Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 2002; 61: 554-558
    Google Scholar
  • 62 Chai J, Logigian EL. Neurological manifestations of primary Sjogren’s syndrome. Curr Opin Neurol 2010; 23: 509-513
    CrossrefPubMedGoogle Scholar
  • 63 Goransson LG, Herigstad A, Tjensvoll AB et al. Peripheral neuropathy in primary Sjogren syndrome: a population-based study. Arch Neurol 2006; 63: 1612-1615
    CrossrefPubMedGoogle Scholar
  • 64 Mori K, Iijima M, Koike H et al. The wide spectrum of clinical manifestations in Sjogren’s syndrome-associated neuropathy. Brain 2005; 128: 2518-2534
    CrossrefPubMedGoogle Scholar
  • 65 Kizawa M, Mori K, Iijima M et al. Intravenous immunoglobulin treatment in painful sensory neuropathy without sensory ataxia associated with Sjögren’s syndrome. J Neurol Neurosurg Psychiatry 2006; 77: 967-969
    CrossrefPubMedGoogle Scholar
  • 66 Kastrup O, Maschke M, Diener HC. Pulse-cyclophosphamide in the treatment of ataxic sensory and cranial nerve neuropathy associated with Sjogren’s syndrome. Clin Neurol Neurosurg 2005; 107: 440-441
    CrossrefPubMedGoogle Scholar
  • 67 Kahlenberg JM, Fox DA. Advances in the medical treatment of rheumatoid arthritis. Hand Clin 2011; 27: 11-20
    CrossrefPubMedGoogle Scholar
  • 68 Curtis JR, Patkar N, Xie A et al. Risk of serious bacterial infections among rheumatoid arthritis patients exposed to tumor necrosis factor alpha antagonists. Arthritis Rheum 2007; 56: 1125-1133
    CrossrefPubMedGoogle Scholar
  • 69 Zhang P, Li X, Li Y et al. Reversible posterior leukoencephalopathy syndrome secondary to systemic-onset juvenile idiopathic arthritis: A case report and review of the literature. Biomed Rep 2015; 3: 55-58
    PubMedGoogle Scholar
  • 70 Bharat A, Xie F, Baddley JW et al. Incidence and risk factors for progressive multifocal leukoencephalopathy among patients with selected rheumatic diseases. Arthritis Care Res (Hoboken) 2012; 64: 612-625
    CrossrefPubMedGoogle Scholar
  • 71 Dixon WG, Hyrich KL, Watson KD et al. B S R B R Control Centre Consortium, Symmons DP; BSR Biologics Register. Drug-specific risk of tuberculosis in patients with rheumatoid arthritis treated with anti-TNF therapy: results from the British Society for Rheumatology Biologics Register (BSRBR). Ann Rheum Dis 2010; 69: 522-528
    CrossrefPubMedGoogle Scholar
  • 72 Chan JW, Castellanos A. Infliximab and anterior optic neuropathy: case report and review of the literature. Graefes Arch Clin Exp Ophthalmol 2010; 248: 283-287
    CrossrefPubMedGoogle Scholar
  • 73 ten Tusscher MP, Jacobs PJ, Busch MJ et al. Bilateral anterior toxic optic neuropathy and the use of infliximab. BMJ 2003; 326: 579
    CrossrefPubMedGoogle Scholar
  • 74 von Jagow B, Kohnen T. Anterior optic neuropathy associated with adalimumab. Ophthalmologica 2008; 222: 292-294
    CrossrefPubMedGoogle Scholar