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Autonomic dysfunction in psoriatic arthritis.
Ashit Syngle1, Inderjeet Verma, Nidhi Garg
1Healing Touch City Clinic, no. 547, Sector 16-D, Chandigarh 160015, India. ashitsyngle@yahoo.com
Clinical Rheumatology
|April 4, 2013
Summary
Psoriatic arthritis (PsA) patients frequently experience autonomic neuropathy, affecting both cardiovascular and peripheral sympathetic functions. Parasympathetic dysfunction is more common than sympathetic dysfunction in PsA.
Area of Science:
- Rheumatology
- Neurology
- Autonomic Function Testing
Background:
- Autonomic nervous system (ANS) dysfunction is recognized in several autoimmune diseases.
- Psoriatic arthritis (PsA) has not been previously investigated for ANS involvement.
Purpose of the Study:
- To determine the prevalence and characteristics of autonomic neuropathy in PsA patients.
- To compare ANS function in PsA patients with healthy controls.
Main Methods:
- Prospective study of 16 PsA patients and 15 age/sex-matched controls.
- Utilized noninvasive tests including cardiovascular reflex tests for cardiovascular autonomic neuropathy (CAN) and Sudoscan for sympathetic function.
- Assessed autonomic symptoms in patients with parasympathetic dysfunction.
Main Results:
- PsA patients showed significantly higher heart rate response to standing, blood pressure response to standing, and Sudoscan scores compared to controls.
- 50% of PsA patients had abnormal CAN, with parasympathetic dysfunction being more prevalent than sympathetic dysfunction.
- Autonomic symptoms were reported by 18.7% of patients with parasympathetic dysfunction; none of the controls had ANS dysfunction.
- Heart rate response correlated with inflammatory markers (ESR, CRP).
Conclusions:
- Cardiovascular autonomic and peripheral sympathetic neuropathy are present in PsA.
- Parasympathetic dysfunction is more common than sympathetic dysfunction in PsA.
- ANS dysfunction in PsA is linked to disease activity and inflammation.
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