AANEM News Express

AANEM News Express

Science News: Associated Conditions in Small Fiber Neuropathy – A Large Cohort Study and Review of the Literature

5/10/2018
 
Submitted by Nandita S. Keole, MD, News Science Editorial Board 
Additional comments by David B. Rosenfield, MD, News Science Editorial Board


de Greefa BTA, Hoeijmakersa JGJ, Gorissen-Brouwersa CML, Geerts M, Faber CG, Merkiesa ISJ. Associated conditions in small fiber neuropathy – a large cohort study and review of the literature. European Journal of Neurology 2018, 25: 348–355.

Small fiber neuropathy (SFN) is a common disorder leading to neuropathic pain and autonomic symptoms. The objective of this study was to investigate associated conditions in a large cohort of SFN patients and compare the prevalence to healthy individuals. 

A total of 921 patients with pure SFN were screened according to a standardized comprehensive diagnostic algorithm and compared with literature findings.

No associated condition could be found in 53% of the patients. Autoimmune diseases, sodium channel gene mutations, diabetes mellitus including glucose intolerance, and vitamin B12 deficiencies were more prevalent than reported literature findings, followed by alcohol abuse, chemotherapy, monoclonal gammopathy of undetermined significance, and haemochromatosis. In patients who were already known with a possible underlying condition at screening, additional underlying conditions were still found in another 26.7% of patients.

Based on these results, it is recommended that patients with pure SFN are screened at least for autoimmune diseases, sodium channel gene mutations, diabetes mellitus including glucose intolerance, and vitamin B12 deficiency, even when they already have a potential underlying condition at referral.

Dr. Keole’s Comments: This study was interesting because it highlights the causes of SFN.

Dr. Rosenfield’s Summary and Comments: The authors of this article remind us of the complex nosology of small fiber neuropathy (SFN). They reviewed a large cohort of SFN patients and note that 43% had at least 1 of the following: autoimmune diseases; sodium channel mutations, diabetes, B-12 deficiencies, alcohol abuse, chemotherapy, monoclonal gammopathy of undetermined significance and haemochromatosis, reminding us once again that the underlying nosology of SFN is extensive.


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