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Diabetic Neuropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Besides diabetes mellitus, other conditions that can cause small fiber neuropathy include endocrine or metabolic disorders, hypothyroidism, hereditary diseases, metabolic syndrome, Fabry disease, hereditary amyloidosis, hereditary sensory autonomic neuropathy, immune system disorders, Tangier disease, celiac disease, Guillain-Barre syndrome, inflammatory bowel disease, lupus erythematosus, mixed connective tissue disease, psoriasis, rheumatoid arthritis, sarcoidosis, scleroderma, Sjögren’s syndrome, infectious diseases, vasculitis, viral hepatitis C, human immunodeficiency virus (HIV), and Lyme disease. Additional causes include chemotherapy, certain medications, alcoholism, and vitamin B 12 deficiencies. Sometimes, small fiber neuropathy is of unknown cause. Risk factors for small fiber neuropathy include all of these conditions, but primarily diabetes mellitus. Age is another risk factor.
Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
About 10% of patients develop neurologic complications, most commonly ataxia and neuropathy. The neuropathy usually presents with distal sensory loss, paresthesias, and unsteadiness. A small fiber neuropathy or autonomic neuropathy may also occur. The neuropathy may be the presenting feature of celiac disease.
Peripheral neuropathies
Published in Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen, Clinical Pain Management, 2008
Ravikiran Shenoy, Katherine Roberts, Praveen Anand
Patients present with distal burning pain in the extremities and have cutaneous hyperesthesiae and autonomic dysfunction as a prominent feature. They have loss of pain and temperature sensation, but preservation of large-fiber modalities, including tendon reflexes. Small-fiber loss has been demonstrated in nerve biopsies.19 Such patients are believed to have small-fiber neuropathy. Small-fiber involvement is an early consistent feature in diabetic polyneuropathy to varying degrees.17
Temperature sensation in Parkinson’s disease measured by quantitative sensory testing: a single-center, case-control study
Published in International Journal of Neuroscience, 2023
Michaela Kaiserova, Anetta Kastelikova, Zuzana Grambalova, Pavel Otruba, Jana Zapletalova, Katerina Mensikova, Raymond Rosales, Petr Kanovsky
Little is known about the abnormal temperature sensation in PD, although the impaired temperature sensation may negatively affect the quality of life in PD. Using QST as a diagnostic method, several studies found an increased temperature threshold in PD [14, 16–18]; other studies did not find any difference between the patients and the control group [13, 26]. Abnormal thermal thresholds may be due to the presence of small fiber neuropathy, as biopsy-proven small fibre neuropathy was detected in up to 56.9% of PD patients [4]. However, central pathology may also play a role in these findings. In our study, only 21% of the patients had increased thermal detection thresholds (CDT or WDT or both) according to the normative data given by Rolke et al [25] and compared to the control group, only CDT on the more affected side in PD was increased. With regard to these findings, abnormal thermal thresholds measured by QST are present only in the minority of patients and do not seem to be a typical finding in PD. The study of Lin et al. found similar results [15]. In their cohort of PD patients, 32.1% had abnormal thermal thresholds.
Clinical and apparative investigation of large and small nerve fiber impairment in mixed cohort of ATTR-amyloidosis: impact on patient management and new insights in wild-type
Published in Amyloid, 2022
Aikaterini Papagianni, Sandra Ihne, Daniel Zeller, Caroline Morbach, Nurcan Üçeyler, Claudia Sommer
Eight of ten ATTRwt patients with generalised IENFD reduction had also clinical and electrophysiological findings of a large-fiber neuropathy. Two patients (one female 61 years old and one male 77 years old) lacking electroneurographic findings of large-fiber neuropathy, had no relevant risk factors for neuropathy, presented with pathological QST and reduction of IENFD. The female patient had a positive history of neuropathic pain, and the male patient complained of distal paraesthesia and gait ataxia. Therefore, after using the diagnostic criteria by Devigili et al. [32], presence of small-fiber neuropathy was diagnosed in these patients. Congo red staining revealed no amyloid deposits in skin biopsies of neither ATTRv nor ATTRwt patients. See also Supplementary Table 2 for histopathological findings.
Small fiber neuropathy in coeliac disease and gluten sensitivity
Published in Postgraduate Medicine, 2019
Panagiotis Zis, Ptolemaios Georgios Sarrigiannis, Dasappaiah Ganesh Rao, David Surendran Sanders, Marios Hadjivassiliou
To our knowledge, this is the largest case series where such an association is described. Previously, Brannagan et al. reported the characteristics of seven patients with CD and small-fiber neuropathy, confirmed by a skin-biopsy, without any electrophysiological evidence of large fiber peripheral neuropathy [20]. Of those, three patients (42.9%) had decreased epidermal nerve fiber density at the proximal thigh or the distal forearm, which was more severe than at the distal leg, suggesting a non-length-dependent process. In our study, only a minority of patients had a non-length-dependent pattern (15.4%), which is more in keeping with the respective figures of non-length dependent pattern of involvement in CD patients with large-fiber neuropathy [21]. This pattern is similar to that described by Gorson et al. [22] suggesting that the primary pathology might be in the dorsal root ganglia rather than the axons themselves. This probably suggests that the asymmetric small fiber neuropathy is a precursor of a sensory ganglionopathy, which eventually will affect the neurons of the large fibers too. However, in order to confirm this, a prolonged follow-up study of a cohort of patients with SFN and CD is needed.