# Carpal Tunnel Syndrome at the Intersection of Internal Medicine, Gastroenterology, and Neurology: A Thorough Examination

## TL;DR

This study explores how carpal tunnel syndrome is linked to biochemical and blood-related changes, suggesting new ways to diagnose and treat the condition.

## Contribution

The study reveals novel biochemical and haematological associations with carpal tunnel syndrome using a multidisciplinary approach.

## Key findings

- CTS-positive patients had elevated calcium and reduced magnesium levels.
- Higher haemoglobin, lymphocyte, and erythrocyte levels were observed in CTS-positive individuals.
- Calcium-magnesium imbalance and erythrocyte indices are significantly associated with CTS risk.

## Abstract

Background/Objectives: This study was designed to investigate the potential clinical, biochemical, haematological, and pathological associations of carpal tunnel syndrome through a multidisciplinary approach encompassing the fields of internal medicine, gastroenterology, and neurology. Methods: The study group (CTS-positive) comprised 265 patients who presented with dyspeptic complaints and underwent upper gastrointestinal endoscopy, gastric antrum biopsy, electromyography, and comprehensive biochemical and haematological analyses. A control group of 265 patients with similar symptoms but without CTS was selected for comparison. A comparative analysis was conducted on clinical findings, gastric biopsy results, and biochemical and haematological parameters. Results: There were no significant differences in age, gender distribution, or gastric biopsy findings (Helicobacter pylori, intestinal metaplasia, atrophy, and dysplasia) between the CTS-positive and CTS-negative groups. However, significant biochemical differences were identified, including elevated calcium and reduced magnesium levels in CTS-positive patients. Haematological evaluations revealed higher lymphocyte, eosinophil, basophil, erythrocyte, haemoglobin, and haematocrit levels, along with reduced neutrophil-to-lymphocyte ratios and red blood cell distribution widths in the CTS-positive group. Further analysis in the form of correlation and logistic regression analyses provided further confirmation of the association of elevated calcium, haemoglobin, and lymphocyte levels with increased risk of CTS. Conclusions: This multidisciplinary study identifies significant associations between CTS and specific biochemical and haematological parameters, notably calcium-magnesium imbalance and erythrocyte indices. These findings suggest underlying biological interactions that may guide future diagnostic and therapeutic strategies for patients with carpal tunnel syndrome.