A Retrospective Study on the Profile and Treatment Response of Patients with Mononeuritis Multiplex and Connective Tissue Diseases

Abstract

Introduction: Though Mononeuritis Multiplex (MM) can be caused by many pathological conditions, vasculitis is the most important cause. Aim: To study clinical features of MM in patients with connective tissue diseases, the time of presentation of MM from disease onset, its association with disease activity, and functional outcome after treatment. Materials and Methods: A retrospective study was conducted at Outpatient Department (OPD) of Madras Medical College (Government Hospital), Chennai, Tamil Nadu, India, between April 2015 to April 2017. The study included medical records of 18 patients with connective tissue disease who had attended the OPD, with sensory and motor symptoms and who was also diagnosed to have MM. Paired t-test was used to find associations. Disease activity levels were determined using various measures and modified Rankin Score (mRS) was used to assess the response to treatment. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 28.0. Results: Of the 18 study subjects 14 (77.8%) were 18-40 years of age, and 10 (55.6%) were females. The mean duration between the time of diagnosis of connective tissue disease and the development of MM was 18.17 months. Ulnar nerve was the most common nerve involved, 11 subjects (61.1%) had ulnar nerve involvement. Axonal neuropathy was present on nerve conduction studies in 17 (94.4%) of the study subjects and sensory symptoms on history were present in 100% of the study subjects. There was a statistically significant difference (p-value <0.001) between the mRS before treatment (3.89) and after treatment (2.78) for a duration of six months. Conclusion: It was seen that the disease activity indices for connective tissue diseases were quite high at the time of development of MM, and starting treatment would helpimprovethe functional outcome as is evident by the difference in mRS.