Abstract Details

Title Is Non-Length-Dependant Small Fiber Sensory Neuropathy an Inflammatory Neuropathy?

Topic Peripheral Nerve

Presentation(s) P01 - (-)

Poster/Presentation
Number 140

Objective

Background BACKGROUND: Inflammatory status of some NLD-SFSN has been suggested in previous reports.

Design/Methods DESIGN/METHODS: We studied 59 patients having SFSN on the criteria of neuropathic pain with normal muscle strength, absence of sensory ataxia, normal nerve conduction study, and reduced intra-epidermal nerve fiber density (IENFD) quantified by skin biopsies performed at distal leg (DL) and at proximal tight (PT). Diagnosis of NLD-SFSN was assumed in 17 patients on reduced IENFD at PT but not at DL. The others patients were classified as LD-SFSN on decreased IENFD only at DL. Features of dysimmune, metabolic or infectious diseases, including analysis of biopsy of minor salivary gland, were screened in all the patients.

Results RESULTS: Patients with NLD-SFSN were younger than patients with LD-SFSN (51 y-o vs. 59 y-o, p=0.029) and were more often female (15/17 vs. 30/42, p=0.17). Onset of sensory symptoms was acute in 8/17 patients (47%) with NLD-SFSN and in 1/42 patients (2%) with LD-SFNP (p<0.01). IENFD was similar at PT in both NLD-SFSN and LD-SFSN patients (5.6 fibers/mm vs. 7.5, p=0.1), and was lower at DL in LD-SFSN (7.7 fibers/mm vs. 1.9, p<0.0001). Association with another disease was identified in 60% of the population. Immune mediated condition was diagnosed in 9/17 (53%) NLD-SFSN (cryoglobulinemia, positive lip biopsy, albumino-cytological dissociation at CSF analysis) and in 10/42 (24%) LD-SFSN (p=0.035). Good efficiency on pain intensity has been observed in 2 NLD-SFN patients after intravenous immunoglobulins infusions. Other conditions associated with NLD-SFSN were bariatric surgery (1) and metabolic syndromes (1).

Conclusions CONCLUSIONS: NLD-SFSN occurs more commonly in younger female, onset is more likely acute and development appears to be more frequently associated with an immune mediated condition. This study confirms that NLD-SFSN is often associated with an inflammatory process.

Authors/Disclosures
Claude J. Desnuelle, MD (CHU De Nice - Hopital Pasteur2) PRESENTER	No disclosure on file
	No disclosure on file
Emilien Delmont, MD	No disclosure on file
Haiel Alchaar, MD (CHU Pasteur)	No disclosure on file
Michel Lanteri-Minet, MD (CHU De Nice)	Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Lanteri-Minet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ipsen. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Orion. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Perfood. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UPSA. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for IPSEN. Dr. Lanteri-Minet has received publishing royalties from a publication relating to health care.
Harold Moses, MD (Vanderbilt Multiple Sclerosis Center)	No disclosure on file
	No disclosure on file
	No disclosure on file

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