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Characteristics of patients with sensory neuropathy diagnosed with abnormal small nerve fibres on skin biopsy
  1. E A De Sousa1,
  2. A P Hays2,
  3. R L Chin1,
  4. H W Sander1,
  5. T H Brannagan III1
  1. 1Weill Medical College of Cornell University, New York, New York, USA
  2. 2Columbia University College of Physicians and Surgeons, New York
  1. Correspondence to:
 Dr Eduardo Adonias De Sousa
 635 Madison Avenue, Ste 400, New York, NY 10022, USA; eadonias{at}


Clinical, laboratory and electrodiagnostic (EDX) characteristics of 62 patients with sensory neuropathy with abnormal skin biopsies were reviewed. Reduced epidermal nerve fibre density (ENFD) was seen in 71% and morphological changes with normal ENFD were seen in 29% of the patients. Patients with small fibre sensory neuropathy may have associated large fibre loss undetected by routine EDX. Identified associations included abnormal glucose metabolism, Lyme vaccination, monoclonal gammopathy, vitamin B12 deficiency, coeliac disease, and diseases of the connective tissue, inflammatory bowel and thyroid. Sensory neuropathy remained undetermined in 50% of the patients.

  • EDX, electrodiagnostic
  • ENFD, epidermal nerve fibre density
  • PPS, pinprick sensation

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  • Presented in abstract form at the 57th AAN Meeting.