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Entrapment syndrome of multiple nerves in graft‐versus‐host disease
Author(s) -
Kleiter Ingo,
Poeschl Peter,
Kraus Peter D.,
Huber Elisabeth,
Schröder Josef,
SchulteMattler Wilhelm,
Holler Ernst,
Wolff Daniel
Publication year - 2014
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.23972
Subject(s) - medicine , pathology , polyneuropathy , epineurium , entrapment neuropathy , graft versus host disease , perineurium , myelin , chronic inflammatory demyelinating polyneuropathy , atrophy , fibrosis , mononeuritis multiplex , histology , anatomy , disease , carpal tunnel syndrome , surgery , peripheral nerve , central nervous system , immunology , antibody , vasculitis
: Peripheral nerve entrapment syndromes are associated with hereditary neuropathy with liability to pressure palsies and a variety of rheumatic and endocrinological diseases. Methods : We report a patient with entrapment syndromes of multiple nerves associated with chronic graft‐versus‐host‐disease (GVHD) after allogeneic hematopoietic stem cell transplantation. Nerve ultrasound, histology, and ultrastructural changes were assessed. Results : The 51‐year‐old man had developed severe deep dermal sclerosis due to chronic GVHD with a progressive polyneuropathy and entrapment syndromes of multiple nerves. Pre‐stenotic enlargement was shown by nerve ultrasound. Histology demonstrated fibrosis of the epineurium with scarce infiltration of macrophages. Electron microscopy demonstrated alterations of the myelin sheaths and marked depletion of normal‐sized myelinated nerve fibers. Conclusions : In addition to polyneuropathy, chronic GVHD can be associated with peripheral nerve entrapment syndromes and should be added to the differential diagnosis of compressive neuropathies. Muscle Nerve 49 : 138–142, 2014