Idiopathic small fiber neuropathy: phenotype, etiologies, and the search for fabry disease.
J Clin Neurol
; 10(2): 108-18, 2014 Apr.
Article
en En
| MEDLINE
| ID: mdl-24829596
ABSTRACT
BACKGROUND AND PURPOSE:
The etiology of small fiber neuropathy (SFN) often remains unclear. Since SFN may be the only symptom of late-onset Fabry disease, it may be underdiagnosed in patients with idiopathic polyneuropathy. We aimed to uncover the etiological causes of seemingly idiopathic SFN by applying a focused investigatory procedure, to describe the clinical phenotype of true idiopathic SFN, and to elucidate the possible prevalence of late-onset Fabry disease in these patients.METHODS:
Forty-seven adults younger than 60 years with seemingly idiopathic pure or predominantly small fiber sensory neuropathy underwent a standardized focused etiological and clinical investigation. The patients deemed to have true idiopathic SFN underwent genetic analysis of the alpha-galactosidase A gene (GLA) that encodes the enzyme alpha-galactosidase A (Fabry disease).RESULTS:
The following etiologies were identified in 12 patients impaired glucose tolerance (58.3%), diabetes mellitus (16.6%), alcohol abuse (8.3%), mitochondrial disease (8.3%), and hereditary neuropathy (8.3%). Genetic alterations of unknown clinical significance in GLA were detected in 6 of the 29 patients with true idiopathic SFN, but this rate did not differ significantly from that in healthy controls (n=203). None of the patients with genetic alterations in GLA had significant biochemical abnormalities simultaneously in blood, urine, and skin tissue.CONCLUSIONS:
A focused investigation may aid in uncovering further etiological factors in patients with seemingly idiopathic SFN, such as impaired glucose tolerance. However, idiopathic SFN in young to middle-aged Swedish patients does not seem to be due to late-onset Fabry disease.
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Base de datos:
MEDLINE
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
J Clin Neurol
Año:
2014
Tipo del documento:
Article