PERIPHERAL NEUROPATHIES IN RHEUMATOID-ARTHRITIS

Noncompressive, nontoxic peripheral neuropathies are uncommon extraart icular manifestations of rheumatoid arthritis. Sensorimotor nerve dama ge due to necrotizing vasculitis is the most prevalent form and may be severe. High-dose intravenous corticosteroids and immunosuppressant a gents (cyclophosphamide) are the mainstay of therapy, whereas plasmaph eresis is warranted only in extremely severe forms. Distal << benign > > sensory neuropathy carries a good prognosis and is usually confined to the lower limbs. Autonomic neuropathy is a probably underdiagnosed complication of rheumatoid arthritis. Epidemiologic studies and contro lled trials are needed to improve the management of peripheral neuropa thy in rheumatoid arthritis patients.