Aetiology of small- and mixed-fiber neuropathy
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| Year of publication | 2006 |
| Type | Conference abstract |
| MU Faculty or unit | |
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| Description | Aim Small-fiber neuropathy (SFN) is reported to be associated with a range of diseases or conditions that are partly different from those associated with large-fiber affection. The aim of the study is to evaluate aetiology in a group of SFN patients in comparison with mixed (i.e., small- and large-) fiber neuropathy (MFN). Methods A detailed medical history was taken and exhaustive blood tests, chest radiography and lumbar puncture were performed in a group of 84 patients with “burning feet” syndrome and clearly proven affection of small nerve fibers (verified by abnormal thermal thresholds and reduced intra-epidermal nerve fiber density in the distal calf). Thirty-three of them also exhibited nerve conduction abnormalities as a sign of large-fibre involvement (MFN group). Results The range and proportions of causes were similar in SFN and MFN subgroups. Diabetes mellitus and chronic alcohol abuse were the most prominent aetiologies (33%; 15%), while further causes were less common and included monoclonal gammopathy, amyloidosis, toxic aetiology, paraneoplastic mechanism, systemic rheumatic diseases, neuroborreliosis, B12 deficiency and critical illness. Hypertriglyceridaemia was demonstrated in more than a third of the patients, but was only mild in most cases. No clear aetiology was found in about 30% of the cases in either subgroup. Conclusions Small-fiber neuropathy is probably not an independent entity, at least from an aetiological point of view. The main causes of both small- and mixed-fiber polyneuropathies in developed countries are diabetes mellitus and chronic alcohol abuse. About one-third of cases remained idiopathic. |
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