Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients.
Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients.
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DOI：
10.1007/s10067-014-2850-5
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发表时间：
2015-03
影响因子：
3.4
通讯作者：
Saperstein, David S.
中科院分区：
文献类型：
--
作者：
Levine, Todd D.;Saperstein, David S.
纤维肌痛是一种临床综合征，目前没有任何特定的病理发现来帮助诊断。因此，纤维肌痛很可能是一组具有相似症状的异质性疾病。识别和理解纤维肌痛的病理基础将使医生能够更好地对患者进行分类，增加前瞻性治疗选择，并改善潜在的治疗努力。最近的研究表明，大约50%的纤维肌痛患者的小无髓神经纤维受损。皮肤穿刺活检是这种损伤的敏感和特异性诊断测试，因为神经纤维密度的降低可以诊断小纤维神经病。小纤维神经病是一种症状类似于纤维肌痛的疾病，但它往往有一个明确的病因。在纤维肌痛患者中识别小纤维神经病变及其根本原因为他们提供了简洁的诊断，增加了治疗选择，并促进了未来治疗方法的更具体研究。
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.
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