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Diagnostic utility of small fiber analysis in skin biopsies from children with chronic pain
Author(s) -
Görlach Jonas,
Amsel Daniel,
Kölbel Heike,
Grzybowsky Michelle,
Rutsch Frank,
Schlierbach Hannah,
Vanlander Arnaud,
PogatzkiZahn Esther,
Habig Kathrin,
Garkisch Stefanie,
Müller Verena,
Fritz Thorsten,
Ziegler Andreas,
Hahn Andreas,
Krämer Heidrun H.,
Van Coster Rudy,
Schänzer Anne
Publication year - 2020
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.26766
Subject(s) - sudomotor , nerve fiber , medicine , skin biopsy , dermatology , pathology , biopsy , anatomy
Abstract Introduction Small fiber neuropathies (SFN) are associated with a reduction in quality of life. In adults, epidermal nerve fiber density (END) analysis is recommended for the diagnosis of SFN. In children, END assessment is not often performed. We analyzed small nerve fiber innervation to elucidate the potential diagnostic role of skin biopsies in young patients with pain. Methods Epidermal nerve fiber density and sudomotor neurite density (SND) were assessed in skin biopsies from 26 patients aged 7 to 20 years (15 female patients) with unexplained chronic pain. The results were compared with clinical data. Results Epidermal nerve fiber density was abnormal in 50% and borderline in 35% of patients. An underlying medical condition was found in 42% of patients, including metabolic, autoimmune, and genetic disorders. Discussion Reduction of epidermal nerve fibers can be associated with treatable conditions. Therefore, the analysis of END in children with pain may help to uncover a possible cause and guide potential treatment options.