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Autonomic dysfunction in psoriatic arthritis

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Abstract

Autonomic nervous system (ANS) involvement has been studied in systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, Sjogren’s syndrome, and ankylosing spondylitis but still has not been studied in psoriatic arthritis (PsA). The aim of this study was to investigate the prevalence and the nature of autonomic neuropathy in patients with PsA. Sixteen patients of PsA and 15 age and sex matched control subjects were studied prospectively using a battery of noninvasive tests. Cardiovascular autonomic neuropathy (CAN) was diagnosed by applying four cardiovascular reflex tests, and peripheral sympathetic autonomic function was assessed by Sudoscan. Patients with PsA had significantly higher heart rate response to standing (p = 0.01), blood pressure response to standing (p = 0.02), and Sudoscan (p = 0.01) when compared with healthy controls. Fifty percent (n = 8) of the patients with PsA had at least two or more abnormal CAN parasympathetic dysfunction; of these, 18.75 % (n = 3) of the patients had abnormal parasympathetic and sympathetic dysfunction, 68.7 % (n = 11) and 25 % (n = 4) of the patients had at least one abnormal parasympathetic and sympathetic parameters, respectively, and 37.5 % (n = 6) of the patients had moderate sudomotor dysfunction. About 18.7 % (n = 3) of our parasympathetic dysfunction patients had autonomic symptoms. None of healthy volunteers had abnormal ANS dysfunction. Heart rate response significantly correlated with erythrocyte sedimentation rate (p < 0.05) and C-reactive protein (p < 0.05) levels. In conclusion, cardiovascular autonomic and peripheral sympathetic neuropathy occurs in PsA. Parasympathetic function is more commonly found to be abnormal than sympathetic function. There is no correlation of peripheral sympathetic dysfunction with cardiovascular autonomic neuropathy.

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Acknowledgments

We gratefully acknowledge the availability of Sudoscan in our center by Impeto Medical, Paris, France.

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Authors and Affiliations

  1. Healing Touch City Clinic, no. 547, Sector 16-D, Chandigarh, 160015, India

    Ashit Syngle

  2. Fortis Multi Speciality Hospital, Mohali, Punjab, India

    Ashit Syngle

  3. Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India

    Inderjeet Verma, Nidhi Garg & Pawan Krishan

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  1. Ashit Syngle
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  2. Inderjeet Verma
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  4. Pawan Krishan
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Correspondence to Ashit Syngle.

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Syngle, A., Verma, I., Garg, N. et al. Autonomic dysfunction in psoriatic arthritis. Clin Rheumatol 32, 1059–1064 (2013). https://doi.org/10.1007/s10067-013-2239-x

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  • DOI: https://doi.org/10.1007/s10067-013-2239-x

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