Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients - PubMed (original) (raw)

Review

Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients

Todd D Levine et al. Clin Rheumatol. 2015 Mar.

Abstract

Fibromyalgia is a clinical syndrome that currently does not have any specific pathological finding to aid in diagnosis. Therefore, fibromyalgia is most likely a heterogeneous group of diseases with similar symptoms. Identifying and understanding the pathological basis of fibromyalgia will allow physicians to better categorize patients, increasing prospective treatment options, and improving potential therapeutic endeavors. Recent work has demonstrated that approximately 50% of patients diagnosed with fibromyalgia have damage to their small unmyelinated nerve fibers. A skin punch biopsy is a sensitive and specific diagnostic test for this damage as a reduction in nerve fiber density allows for the diagnosis of small fiber neuropathy. Small fiber neuropathy is a disease with symptoms similar to fibromyalgia, but it often has a definable etiology. Identifying small fiber neuropathy and its underlying cause in fibromyalgia patients provides them with a succinct diagnosis, increases treatment options, and facilitates more specific studies for future therapeutics.

PubMed Disclaimer

Similar articles

• Small nerve fiber involvement in patients referred for fibromyalgia.
  Giannoccaro MP, Donadio V, Incensi A, Avoni P, Liguori R. Giannoccaro MP, et al. Muscle Nerve. 2014 May;49(5):757-9. doi: 10.1002/mus.24156. Epub 2014 Jan 28. Muscle Nerve. 2014. PMID: 24469976
• Improvement of Nerve Fiber Density in Fibromyalgia Patients Treated with IVIg.
  Metyas S, Chen C, Quismorio A, Abdo N, Kamel K. Metyas S, et al. Curr Rheumatol Rev. 2020;16(4):280-284. doi: 10.2174/1573397115666191106120622. Curr Rheumatol Rev. 2020. PMID: 31702528
• Evidence of abnormal epidermal nerve fiber density in fibromyalgia: clinical and immunologic implications.
  Caro XJ, Winter EF. Caro XJ, et al. Arthritis Rheumatol. 2014 Jul;66(7):1945-54. doi: 10.1002/art.38662. Arthritis Rheumatol. 2014. PMID: 24719395
• The cutaneous nerve biopsy: technical aspects, indications, and contribution.
  Mellgren SI, Nolano M, Sommer C. Mellgren SI, et al. Handb Clin Neurol. 2013;115:171-88. doi: 10.1016/B978-0-444-52902-2.00010-2. Handb Clin Neurol. 2013. PMID: 23931780 Review.
• Clinical and diagnostic features of small fiber damage in diabetic polyneuropathy.
  Javed S, Petropoulos IN, Tavakoli M, Malik RA. Javed S, et al. Handb Clin Neurol. 2014;126:275-90. doi: 10.1016/B978-0-444-53480-4.00019-9. Handb Clin Neurol. 2014. PMID: 25410229 Review.

Cited by

• Lower Functional Connectivity of the Periaqueductal Gray Is Related to Negative Affect and Clinical Manifestations of Fibromyalgia.
  Coulombe MA, Lawrence KS, Moulin DE, Morley-Forster P, Shokouhi M, Nielson WR, Davis KD. Coulombe MA, et al. Front Neuroanat. 2017 Jun 8;11:47. doi: 10.3389/fnana.2017.00047. eCollection 2017. Front Neuroanat. 2017. PMID: 28642688 Free PMC article.
• Small Fiber Neuropathy in Veterans With Gulf War Illness.
  Shadiack EC 3rd, Osinubi O, Gruber-Fox A, Bhate C, Patrick-DeLuca L, Cohen P, Helmer DA. Shadiack EC 3rd, et al. Fed Pract. 2024 May;41(5):136-141. doi: 10.12788/fp.0470. Epub 2024 May 15. Fed Pract. 2024. PMID: 39398967 Free PMC article.
• Hypothesis: Human papillomavirus vaccination syndrome--small fiber neuropathy and dysautonomia could be its underlying pathogenesis.
  Martínez-Lavín M. Martínez-Lavín M. Clin Rheumatol. 2015 Jul;34(7):1165-9. doi: 10.1007/s10067-015-2969-z. Epub 2015 May 20. Clin Rheumatol. 2015. PMID: 25990003 Review.
• Immune System Involvement in Specific Pain Conditions.
  Totsch SK, Sorge RE. Totsch SK, et al. Mol Pain. 2017 Jan-Dec;13:1744806917724559. doi: 10.1177/1744806917724559. Mol Pain. 2017. PMID: 28741433 Free PMC article. Review.

References

1. 1. Wolfe F, Clauw DJ, Fitzcharles M-A, Goldenberg DL, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB, Yunus MB. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62:600–610. doi: 10.1002/acr.20140. - DOI - PubMed
2. 1. Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, Barton DL, St. Sauver J. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res. 2013;65:786–792. doi: 10.1002/acr.21896. - DOI - PMC - PubMed
3. 1. Clauw DJ. Fibromyalgia. JAMA. 2014;311:1547–1555. doi: 10.1001/jama.2014.3266. - DOI - PubMed
4. 1. Oaklander AL, Herzog ZD, Downs HM, Klein MM. Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia. Pain. 2013;154:2310–2316. doi: 10.1016/j.pain.2013.06.001. - DOI - PMC - PubMed
5. 1. Devigili G, Tugnoli V, Penza P, Camozzi F, Lombardi R, Melli G, Broglio L, Granieri E, Lauria G. The diagnostic criteria for small fibre neuropathy: from symptoms to neuropathology. Brain. 2008;131:1912–1925. doi: 10.1093/brain/awn093. - DOI - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources

• Full Text Sources

  • Europe PubMed Central
  • PubMed Central
  • Springer

• Other Literature Sources

  • scite Smart Citations

• Medical

  • MedlinePlus Health Information