Small Fiber Neuropathy: Clinicopathological Correlations

Small fiber neuropathy develops due to the selective damage of the thin fibers of peripheral nerves. Many common diseases can cause this condition, including diabetes, infections, autoimmune and endocrine disorders, but it can occur due to genetic alterations, as well. Eighty-five skin biopsy-proven...

Full description

Saved in:
Bibliographic Details
Main Authors: Endre Pál, Krisztina Fülöp, Péter Tóth, Gabriella Deli, Zoltán Pfund, József Janszky, Sámuel Komoly
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Behavioural Neurology
Online Access:http://dx.doi.org/10.1155/2020/8796519
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849683418274594816
author Endre Pál
Krisztina Fülöp
Péter Tóth
Gabriella Deli
Zoltán Pfund
József Janszky
Sámuel Komoly
author_facet Endre Pál
Krisztina Fülöp
Péter Tóth
Gabriella Deli
Zoltán Pfund
József Janszky
Sámuel Komoly
author_sort Endre Pál
collection DOAJ
description Small fiber neuropathy develops due to the selective damage of the thin fibers of peripheral nerves. Many common diseases can cause this condition, including diabetes, infections, autoimmune and endocrine disorders, but it can occur due to genetic alterations, as well. Eighty-five skin biopsy-proven small-fiber neuropathy cases were analyzed. Forty-one (48%) cases were idiopathic; among secondary types, hypothyreosis (9.4%), diabetes mellitus (7%), cryoglobulinemia (7%), monoclonal gammopathy with unproved significance (4.7%), Sjögren’s disease (3%), and paraneoplastic neuropathy (3%) were the most common causes. Two-thirds (68%) of the patients were female, and the secondary type started 8 years later than the idiopathic one. In a vast majority of the cases (85%), the distribution followed a length-dependent pattern. Intraepidermal fiber density was comparable in idiopathic and secondary forms. Of note, we found significantly more severe pathology in men and in diabetes. Weak correlation was found between patient-reported measures and pathology, as well as with neuropathic pain-related scores. Our study confirmed the significance of small fiber damage-caused neuropathic symptoms in many clinical conditions, the gender differences in clinical settings, and pathological alterations, as well as the presence of severe small fiber pathology in diabetes mellitus, one of the most common causes of peripheral neuropathy.
format Article
id doaj-art-d7d3a1f664864dc8bbcac08ae95c3b96
institution DOAJ
issn 0953-4180
1875-8584
language English
publishDate 2020-01-01
publisher Wiley
record_format Article
series Behavioural Neurology
spelling doaj-art-d7d3a1f664864dc8bbcac08ae95c3b962025-08-20T03:23:52ZengWileyBehavioural Neurology0953-41801875-85842020-01-01202010.1155/2020/87965198796519Small Fiber Neuropathy: Clinicopathological CorrelationsEndre Pál0Krisztina Fülöp1Péter Tóth2Gabriella Deli3Zoltán Pfund4József Janszky5Sámuel Komoly6Department of Neurology, University of Pécs, Medical School, Pécs, HungaryDepartment of Pathology, Neuropathology Unit, University of Pécs, Medical School, Pécs, HungaryDepartment of Neurology, University of Pécs, Medical School, Pécs, HungaryDepartment of Neurology, University of Pécs, Medical School, Pécs, HungaryDepartment of Neurology, University of Pécs, Medical School, Pécs, HungaryDepartment of Neurology, University of Pécs, Medical School, Pécs, HungaryDepartment of Neurology, University of Pécs, Medical School, Pécs, HungarySmall fiber neuropathy develops due to the selective damage of the thin fibers of peripheral nerves. Many common diseases can cause this condition, including diabetes, infections, autoimmune and endocrine disorders, but it can occur due to genetic alterations, as well. Eighty-five skin biopsy-proven small-fiber neuropathy cases were analyzed. Forty-one (48%) cases were idiopathic; among secondary types, hypothyreosis (9.4%), diabetes mellitus (7%), cryoglobulinemia (7%), monoclonal gammopathy with unproved significance (4.7%), Sjögren’s disease (3%), and paraneoplastic neuropathy (3%) were the most common causes. Two-thirds (68%) of the patients were female, and the secondary type started 8 years later than the idiopathic one. In a vast majority of the cases (85%), the distribution followed a length-dependent pattern. Intraepidermal fiber density was comparable in idiopathic and secondary forms. Of note, we found significantly more severe pathology in men and in diabetes. Weak correlation was found between patient-reported measures and pathology, as well as with neuropathic pain-related scores. Our study confirmed the significance of small fiber damage-caused neuropathic symptoms in many clinical conditions, the gender differences in clinical settings, and pathological alterations, as well as the presence of severe small fiber pathology in diabetes mellitus, one of the most common causes of peripheral neuropathy.http://dx.doi.org/10.1155/2020/8796519
spellingShingle Endre Pál
Krisztina Fülöp
Péter Tóth
Gabriella Deli
Zoltán Pfund
József Janszky
Sámuel Komoly
Small Fiber Neuropathy: Clinicopathological Correlations
Behavioural Neurology
title Small Fiber Neuropathy: Clinicopathological Correlations
title_full Small Fiber Neuropathy: Clinicopathological Correlations
title_fullStr Small Fiber Neuropathy: Clinicopathological Correlations
title_full_unstemmed Small Fiber Neuropathy: Clinicopathological Correlations
title_short Small Fiber Neuropathy: Clinicopathological Correlations
title_sort small fiber neuropathy clinicopathological correlations
url http://dx.doi.org/10.1155/2020/8796519
work_keys_str_mv AT endrepal smallfiberneuropathyclinicopathologicalcorrelations
AT krisztinafulop smallfiberneuropathyclinicopathologicalcorrelations
AT petertoth smallfiberneuropathyclinicopathologicalcorrelations
AT gabrielladeli smallfiberneuropathyclinicopathologicalcorrelations
AT zoltanpfund smallfiberneuropathyclinicopathologicalcorrelations
AT jozsefjanszky smallfiberneuropathyclinicopathologicalcorrelations
AT samuelkomoly smallfiberneuropathyclinicopathologicalcorrelations