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Comorbidity of peripheral neurodegenerative diseases with osteoarticular polyalgic pathology

Autor: Constantin Lupu Loriana Feier Adriana Cojocaru Andrea Șiclovan
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Th e coexistence of diff erent organic pathologies that multiplies the semiological picture of a disease, it is a common situation in the evolutionary pathology of apparently defi nitive clinical schedules. We refer to the common genetic and embryonic etiopathogenesis that should attract our permanent attention.
All these clinical forms benefit from specific therapies and pain treatments.
Key words: peripheral neurological paralysis, arthropathy, dermatological pathology, chronic pain, acute exacerbations

We aim to recall the different associations of the pathology from syndromes and somatic diseases with degenerative neurological diseases manifested as peripheral paralysis, trophic and atrophic disorders, accompanied by osteoarthropathies, named and described by observers, discoverers, clinicians and doctors in step with scientific reaserch of the 19th and 20th centuries.
Mainly, our material provides the description of genetic etiopathogenesis by mono or polygenic mutations inducing neurodegenerative diseases in tandem with skin, osteoarticular or mesenchymal pathology. These degenerative pathogenic mechanisms always impair motility and sensory activity, resulting in deficient clinical forms from analgesia to hyperalgesia.
Having common embryogenesis, the teguments and neuronal columns of the spinal cord will have comorbidities resulting from mutations, autosomal recessive pathology and/or embryo-fetalopathies. Gene polymorphism will have repercussions on osteogenesis, vasculoconjunctive tissues that generate painful inflammatory mechanisms [4,6].
The most common expression of these situations in children and adolescents is found in dermatological pathology, especially in Psoriasis, in Dermatomyositis and Polymyositis, in the pathology of connective tissues from different diseases that we describe below. Painful arthralgias accompany the various forms of Psoriasis (Pso.), Ie in Pso. Vulgar, Pso. Gutous, Pso. Erythrodermic, Pso. Pustulous or in Parapsoriazis in early childhood, but especially in puberty and adolescence [4]. Psoriatic osteoarthritis and arthroplasty, in hemartrosis or phakomatoses are accompanied by osteogenetic deficiencies with osteoporosis, nail clogging and gingival disorders [3]. If the pathology of onset of psoriasis is initially presented at the Family Medicine office, which may indicate a dermatological hereditary aspect, then the Pediatrics office will initially direct the patient to rheumatology and to paraclinical investigations, and in evolution, the patient will reach the dermatologist clinicians, who will prescribes specific therapies for psoriasis [7]. The complete diagnosis is obtained by genotyping the cases [2]. The pathophysiology of psoriatic osteoarthritis and other arthropathies consists of decreased cartilage, inflammation of sensory terminations, presence of peri and intra-articular psoriatic nanoparticles, development of psoriatic tegumentary pruritic scabs.
Similar pathognomonic situations are also found in Paracheratosis in shields: Unna disease and in different locations of Recklinghausen’s disease with different joint, bone and spinal pain. The enumeration of syndromes and diseases with paralysis, atrophy and arthropathy is necessary for the selection of the differential diagnoses required in algiology: Friedreich’s disease – the classic paralysis of sensory-motor neuropathies, Aron-Duchenne’s disease: inferior joint paralysis, Arnold’s disease – Hypertrophendous osteoarthropathy, Musculoskeletal osteoarthropathy, Retrophayophageal osteoarthropathy deformities of the spine and of the joints Little, Osteodermatopathy Marie-Pierre, Vulpian-Bernard disease with neuralgia and arthralgia of different intensities Dermatomyositis and polymorphisms UnverichtWagner with arthritis, severe arthropathy and chondrodystrophy of the immobilizers, blockages and super-limbs, being blocked of chronic pain and acute exacerbations [8]. These clinical forms of pain benefit from symptomatic therapies with NSAIDs, diazepinic sedatives [9] cannabinic and morphine [8] as well as therapies associated with thermal baths, including herbs, unconventional therapies such as Ozonotherapy and Kinetotherapy.

1. Covic A, Stefanescu D, Sandovici I, Gorduza V. GENETICA UMANA Editia3 Polirom Iasi -2003
2. Șt. Olteanu, Rodica Olteanu, Psoriazisul – de la istorie la realitatea unei boli unice sau de ce psoriazisul este o boalã unicã? Psoriasis, from history to the reality of a single disease or why psoriasis is a unique disease?, Revista Societăţii Române de Dermatologie (
S.D.R.), vol. 58, nr.3/2013, pag. 209-2015
3. Burgos-Pol R, Martínez-Sesmero JM, Ventura-Cerdá JM et al., Th e Cost of Psoriasis and Psoriatic Arthritis in 5 European Countries: A Systematic Review, Actas Dermosifi liogr. 2016 Sep;Nr.107(7):577-90. Nr 2: 10.1016/ Epub 2016 Jun 15.
4. Duffi n KC, Chandran V, Gladman DD et al., Genetics of psoriasis and psoriatic arthritis: update and future direction, J. Rheumatol. 2008 Jul;35(7):1449-53.
5. Ehlers E, Dermat. Wschr Leipzig no. 8/1899, pag 173-175
6. M. Geormaneanu, Patologia indusă prenatal, Editura Medicală, București, 1978
7. MC Kusik V.A, Aff ection hereditaries du tissue conjunctiff in Harrison IR, Principles de Medicine Interne, Ed. Flamarin Paris 1975
8. Mease P.J et al, Etanercept in the treatment of Psoriatic arthritis and psoriazis, Lancet 200, pag. 356-390
9. Mungiu O, Săndesc D, Terapia durerii, Ed.II-a revizuită şi adaugată 2008; Ed. Etna, București