Background Neuropathy is a common feature of collagen tissue disorders. Although development of digital ulcerations may be associated with presence of neuropathy, percentage of systemic sclerosis (SSc) patients with documented neuropathy is low. Quantitative sensory testing (QST) has been used to detect and characterize neuropathies.
Objectives The aim of this study is to evaluate the patients with SSc by using QST for the presence of small and large fiber neuropathies and to investigate the association between digital ulcers and neuropathy.
Methods We studied 50 SSc patients (46 (92%) were female). Demographic and clinical features of all patients were recorded. Michigan Neuropathy Screening Instrument (MNSI) questionnaire was performed in all subjects. MNSI questionnaire score ≥4 was considered to be abnormal. QST was performed using a CASE IV machine (WR Medical Electronics, Stillwater, Minnesota). Vibration and cold detection thresholds were measured using a 4, 2, and 1 stepping algorithm with null stimuli in the left foot and left hand. An increased threshold was defined as >99 percentile.
Results The mean age and the median disease duration of SSc patients was 47±12 years, 111 (12- 480) months, respectively. Thirty (60%) patients had limited SSc The median modified Rodnan's score of the patients was 7 (3-29). Thirty (60%) patients had digital ulcer history. Ten (20%) patients had ≥4 MNSI questionnaire scores. The abnormal hand and foot vibration-detection thresholds were found in 26 (52%) and 20 (40%) patients. The abnormal hand and food cold-detection thresholds were found in 3 (6%) and 7 (14%) patients. The mean disease duration or the mean hand MRS were not different between patients with or without abnormal QST values for cold or vibration detected thresholds (p NS for all). Number of patients with DU history or SSc type were not different between patients with abnormal QST values for cold or vibration detected thresholds or not (p NS for all).
Conclusions This study revealed that although there were significant percent of SSc patiens who had abnormal cold and vibration threshold values by QST, there were no association of clinical features of SSc with abnormal QST values.
Disclosure of Interest None declared
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