Abstract Details

Title Identification of Symptomatic and Asymptomatic Small Fiber Neuropathy (SFN) in Patients with Rheumatic Disorders

Topic Peripheral Nerve

Presentation(s) P01 - (-)

Poster/Presentation
Number 142

Objective

Background BACKGROUND: Reduced intraepidermal nerve fiber density (IENFD) has been reported in some patients with rheumatic disorders but a prospective systematic study with controls has not been performed. In Sjogren syndrome (SS), we have found that SFN is the most common neuropathy (Pavlakis et al J Autoimm. 2012).

Design/Methods DESIGN/METHODS: 22 patients with various rheumatic disorders (7 RA, 5 SLE, 6 Sjogren's, 3 psoriatic arthritis, 1 ankylosing spondylitis) aged 30-74 years (mean 54,1), and 7 healthy volunteers (aged 19-54, mean: 32,4), underwent a skin biopsy in the foot. Ten of the 22 patients reported painful paresthesias or diffuse pains; the other 12 were asymptomatic. All have been treated with steroids or immunosuppressants. Factors associated with SFN were excluded. Skin biopsies were immunostained with PGP. Counting was performed by two independed observers trained in skin biopsy methodology, following EFNS/PNS guidelines.

Results RESULTS: The IENFD in the rheumatologic patients ranged from 1,47-13,6 fibers/mm (mean 5,5; SD +/-3,11); in the controls IENFD ranged from 7,2 to 11,5 fibers/mm (mean: 8,4 +/- 1,64) [p=0,004] . IENFD was abnormal in 9 of 10 symptomatic patients (mean: 5,4 +/-3,2) and in 10 of 12 asymptomatic ones (mean 5,6 +/-2,9).

Conclusions CONCLUSIONS: Reduction in IENFD is frequent in rheumatic disorders. Because many of these patients were asymptomatic, long-term follow up is needed to assess the significance of the observation and determine whether they will develop clinical symptoms. The causative implication of immune or toxic factors is currently explored in our laboratory.

Authors/Disclosures
PRESENTER	No disclosure on file
Lukia Koutsogeorgopoulou	No disclosure on file
	No disclosure on file
	No disclosure on file
Haralambos Alexopoulos (University of Athens)	No disclosure on file
	No disclosure on file
Marinos C. Dalakas, MD, FAAN (Thomas Jefferson University)	Dr. Dalakas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Grifols, . Dr. Dalakas has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Dysimmune Diseases Foundation. Dr. Dalakas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octapharma. Dr. Dalakas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ARGENX. Dr. Dalakas has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. Dr. Dalakas has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Therapeutic Advances in Neurology (TAND). Dr. Dalakas has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink.
	No disclosure on file

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