{
  "abstract": "Introduction Peripheral nervous system (PNS) involvement in systemic sclerosis (SSc) is still poorly understood, leaving many patients at risk of unrecognized neuropathic pain. A better understanding of the prevalence of neuropathic pain and its association with polyneuropathy in SSc is needed.Material and Methods A total of 103 patients with confirmed SSc were identified from hospital databases in Latvia. Nerve conduction studies (NCS) were conducted to evaluate large-fiber polyneuropathy (PNP). Patients were assessed using the shortened and revised Total Neuropathy Score (srTNS). Additionally, participants completed the Latvian version of the Douleur Neuropathique en 4 (DN4) questionnaire to evaluate neuropathic pain. Associations between PNP, gender, and abnormal TNS were examined using logistic regression, and odds ratios (OR) with 95% confidence intervals (CI) were reported. To explore whether the association between PNP and neuropathic pain (assessed by the DN4) differed by gender, logistic regression models with interaction terms were fitted. Marginal predicted probabilities with 95% CIs were calculated from these models using the margins command in Stata. A p-value <0.05 was considered statistically significant.Results 82.52% of patients were women, with mean age 61.38 years (+- 12.48) and mean SSc duration 14.06 years (+- 9.62). 43 patients (41.75%) were diagnosed with PNP by NCS, 67% of men with SSc had PNP, less frequent in women (37%), p=0.018. Patients with PNP had 18 times higher odds of abnormal TNS (OR 18.1, 95% CI 3.9–83.7, p<0.001). Gender was not significantly associated with TNS, and no meaningful interaction between PNP and gender could be estimated due to complete separation.In margins analysis, the predicted probability of DN4-positive neuropathic pain was 25% (95% CI 0.5–49.5%) in men with PNP compared to 33% (95% CI –4.4–71.1%) in men without PNP. Among women, the probability was 57% (95% CI 38.9–74.4%) in those with PNP versus 36% (95% CI 22.9–48.8%) in those without. Although the association between PNP and neuropathic pain appeared stronger in women, the interaction term was not statistically significant (OR 3.51, 95% CI 0.34–36.05, p=0.291).Conclusions Peripheral nervous system involvement is common in systemic sclerosis. Large-fiber polyneuropathy was detected in over 40% of patients and was strongly associated with abnormal total neuropathy scores. Neuropathic pain, as assessed by DN4, showed a tendency to be more prevalent in women with polyneuropathy, although the gender interaction was not statistically significant. These findings highlight the importance of systematic evaluation of neuropathic complications in SSc to improve recognition and management.Abstract P.354 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Riga Stradins University, Riga, Latvia"
      ],
      "name": "Kristine Ivanova"
    },
    {
      "affiliations": [
        "Riga Stradins University, Riga, Latvia",
        "Pauls Stradins Clinical university hospital, Riga, Latvia"
      ],
      "name": "Natalja Kurjane"
    },
    {
      "affiliations": [
        "Riga Stradins University, Riga, Latvia",
        "Pauls Stradins Clinical university hospital, Riga, Latvia"
      ],
      "name": "Viktorija Kenina"
    }
  ],
  "title": "P.354 Peripheral nervous system complications in systemic sclerosis: association between polyneuropathy and neuropathic pain",
  "uid": "31e672ee-f535-5cf3-84e6-d21d7af7e9ff"
}