RESUMO
INTRODUCTION: Pain mechanisms in fibromyalgia syndrome (FMS) are not clearly understood. Growing evidence appears to suggest a role for small fiber polyneuropathy (SFPN) in some FMS patients, as measured by epidermal nerve fiber density (ENFD). We aimed to better characterize and distinguish the subset of patients with both fibromyalgia and small fiber, early or mild sensory polyneuropathy (FM-SFSPN). METHODS: 155 FMS patients with neuropathic symptoms completed a Short Form McGill Questionnaire and visual analog scale in addition to having skin biopsies, nerve conduction studies (NCS), and serologic testing. RESULTS: Sural and medial plantar (MP) response amplitudes correlated with ENFD, with markers of metabolic syndrome being more prevalent in this subset of patients. Pain intensity and quality did not distinguish patients. DISCUSSION: The FM-SFSPN subset of patients may be identified through sural and MP sensory NCS and/or skin biopsy but cannot be identified by pain features and intensity. Muscle Nerve 58: 625-630, 2018.
Assuntos
Fibromialgia/diagnóstico , Fibromialgia/fisiopatologia , Neuropatia de Pequenas Fibras/fisiopatologia , Adulto , Biópsia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Condução Nervosa/fisiologia , Medição da Dor , Curva ROC , Pele/patologiaRESUMO
Progressive multifocal leukoencephalopathy (PML) is a viral demyelinating disease due to the reactivation of the JC virus (JCV), which usually occurs in the context of immunosuppression in HIV infection, malignancy, or in patients on disease modifying therapy for autoimmune diseases, such as multiple sclerosis (MS) and Crohn's disease. Notably, there is growing recognition that PML can occur in patients with transient immune dysfunction. Here, we present a case of a 55-year-old man without history of immunosuppression or evidence of ICL who was diagnosed with PML on brain biopsy. We will discuss the potential etiologies of mild and transient immunosuppression that can lead to PML with non-apparent immunosuppression.
Assuntos
Encéfalo/patologia , Disfunção Cognitiva/patologia , Diplopia/patologia , Leucoencefalopatia Multifocal Progressiva/patologia , Incontinência Urinária/patologia , Vertigem/patologia , Encéfalo/diagnóstico por imagem , Encéfalo/imunologia , Encéfalo/virologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/imunologia , Disfunção Cognitiva/virologia , Diplopia/diagnóstico por imagem , Diplopia/imunologia , Diplopia/virologia , Progressão da Doença , Evolução Fatal , Humanos , Imunocompetência , Vírus JC/imunologia , Vírus JC/isolamento & purificação , Leucoencefalopatia Multifocal Progressiva/diagnóstico por imagem , Leucoencefalopatia Multifocal Progressiva/imunologia , Leucoencefalopatia Multifocal Progressiva/virologia , Masculino , Pessoa de Meia-Idade , Incontinência Urinária/diagnóstico por imagem , Incontinência Urinária/imunologia , Incontinência Urinária/virologia , Vertigem/diagnóstico por imagem , Vertigem/imunologia , Vertigem/virologiaRESUMO
The original version of the article unfortunately contained a typo error in second author name in the author group. The author name was incorrectly published as "Jesse Grewal" and the correct name is "Jessie Grewal".