Abstract Details

Title Sweat Gland Nerve Fiber Density by Skin Biopsy: Frequency of Abnormalities and Clinical Characteristics

Topic Peripheral Nerve

Presentation(s) S26 - (-)

Poster/Presentation
Number 001

Objective

Background Small fiber sensory neuropathy has been diagnosed based on ENFD findings by skin biopsy. More recently, determination of SGNFD has been used for the same purpose, although little is known about its clinical utility or the characteristics of patients with the sole finding of an abnormal SGNFD.

Design/Methods Retrospective chart review of all patients with skin biopsies obtained within the last five years at the Weill Cornell Peripheral Neuropathy Center. All patients typically had sensory symptoms with preserved strength and normal/non-diagnostic routine EMG/NCS.

Results Of the 218 cases (137 women, 81 men), 122 (56%) were Normal and 96 (44%) were Abnormal. The Abnormal group was subdivided into three groups: Abnormal SGNFD Only (28/96, 29%); Abnormal ENFD Only (29/96, 30%); and Abnormal SGND and ENFD (39/96, 41%). Patients with Abnormal SGNFD Only (when compared with patients with Abnormal ENFD Only) were predominantly male (93% vs 28%) and younger (mean age=42 vs 56). They were also more likely to have sensory symptoms involving the torso (36% vs 14.3%), less likely to have absent ankle reflexes (13% vs 54%) or impaired vibration sense on exam (43% vs 70%), and less likely to have a diagnosis of diabetes or glucose intolerance (20% vs 39%).

Conclusions An abnormal SGNFD was the sole finding in 30% of our abnormal subjects. Assessment of SGNFD may increase the ability to diagnose a small fiber neuropathy that would be missed by ENFD analysis alone. Patients with an abnormal SGNFD/normal ENFD may comprise a different clinical subset of small fiber neuropathy that is worth investigating prospectively.

Authors/Disclosures
Joshua J. Weaver, MD, FAAN PRESENTER	Dr. Weaver has nothing to disclose.
	No disclosure on file
Kyung-Wha Kim, MD (grady memorial hospital)	No disclosure on file
Bridget T. Carey, MD	No disclosure on file
Jennifer A. Langsdorf, MD	Dr. Langsdorf has nothing to disclose.
Russell L. Chin, MD	No disclosure on file
	No disclosure on file

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