Rheumatologisch bedingte neurologische Erkrankungen

Zusammenfassung

Rheumatologische Erkrankungen gehören zu den weltweit häufigsten Ursachen für eine krankheitsbedingte signifikante Einschränkung der Lebensqualität und Lebenserwartung und verursachen signifikante volkswirtschaftliche Kosten. Gerade bei der rheumatoiden Arthritis, beim systemischen Lupus erythematodes, beim Sjögren-Syndrom und der ankylosierenden Spondylitis sind neurologische Begleiterkrankungen sehr häufig. Dabei sind alle Bereiche vom ZNS über das periphere Nervensystem bis hin zur Muskulatur betroffen. Am häufigsten sind sicherlich neben einer krankheitsbegleitenden Depression Polyneuropathien in sehr unterschiedlicher Ausprägung. Subklinisch sind nach Studien z. B. bis zu 85% der Patienten mit einer rheumatoiden Arthritis von einer PNP betroffen. Darüber hinaus können in der Therapie rheumatologischer Erkrankungen verwandte Medikamente wie vor allem monoklonale Antikörper zu neurologischen Nebenwirkungen inklusive der Entwicklung einer progressiven multifokalen Leukoenzephalopathie führen. Vor diesem Hintergrund ist es wichtig, rheumatologische Erkrankungen in die Differenzialdiagnose bei neu aufgetretenen neurologischen Erkrankungen einzubeziehen.

Abstract

Rheumatological disorders are amongst the most frequent diseases worldwide leading to significant disability, loss of quality of life, increased mortality and are accompanied by high social costs. In particular, rheumatoid arthritis, sytemic lupus erythematodes and Sjögren syndrome as well as ankylosing spondylitis frequently result in neurological diseases. All parts of the nervous system and the muscles may be involved. Following depressive disorders, most frequently are peripheral neuropathies of various types. Studies have revealed that around 85% of all patients with rheumatoid arthritis are subclinically affected by neuropathies. In addition, antirheumatoid medications such as monoclonal antibodies may result in neurological side effects including progressive multifocal leukoencephalopathy. Against this background, it is important to include rheumatological disorders in the differential diagnosis and work-up of neurological diseases.

Schlüsselwörter

Rheumatoide Arthritis - Lupus erythematodes - Sjögren-Syndrom - Ankylosierende Spondylitis

Keywords

rheumatoid arthritis - lupus erythematodes - sjögren syndrome - ankylosing spondylitis

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