The histopathological evaluation of small fiber neuropathy in patients with vitamin B12 deficiency

Small fiber neuropathy (SFN), due to loss of A-delta and unmyelinated C fibers, is a cause of neuropathic pain. Although the patients with vitamin B12 deficiency are included in SFN studies in the literature, there is no histopathological study investigating the small fiber loss solely in patients w...

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Bibliographic Details
Published in:Acta neurologica Belgica 2018-09, Vol.118 (3), p.405-410
Main Authors: Güneş, Hafize Nalan, Bekircan-Kurt, Can Ebru, Tan, Ersin, Erdem-Özdamar, Sevim
Format: Article
Language:English
Subjects:
Adult
Aged
Biomedical and Life Sciences
Biomedicine
Biopsy
Female
Humans
Male
Medicine/Public Health
Middle Aged
Nerve Fibers - pathology
Neuralgia - diagnosis
Neuralgia - pathology
Neurology
Neuroradiology
Neurosciences
Original Article
Pilot Projects
Skin - innervation
Skin - pathology
Small Fiber Neuropathy - diagnosis
Small Fiber Neuropathy - etiology
Small Fiber Neuropathy - pathology
Vitamin B 12 Deficiency - complications
Young Adult
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Summary:Small fiber neuropathy (SFN), due to loss of A-delta and unmyelinated C fibers, is a cause of neuropathic pain. Although the patients with vitamin B12 deficiency are included in SFN studies in the literature, there is no histopathological study investigating the small fiber loss solely in patients with vitamin B12 deficiency. In this pilot study, we aim to demonstrate the intraepidermal nerve fiber density (IENFD) in skin punch biopsy of patients with vitamin B12 deficiency. Ten patients with vitamin B12 deficiency suffering from neuropathic pain and as control group ten patients with vitamin B12 deficiency without neuropathic pain were included. Neurological examination, electrophysiological evaluation, and DN4 questionnaire were performed. Subsequently, skin punch biopsy 10 cm above the lateral malleolus was done. The biopsy samples were stained with PGP9.5 antibody, and IENFD was determined. IENFD was low in two groups compared to their age normative values. The median of IENFD was 3.345 (1.12–5.32) in patients with neuropathic pain and 6. 20 (4.6–9.8) in controls ( p  
ISSN:0300-9009
2240-2993
DOI:10.1007/s13760-017-0847-y