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. 2010 Dec;257(12):2086-90.
doi: 10.1007/s00415-010-5664-7. Epub 2010 Jul 20.

Pain and autonomic dysfunction in patients with sarcoidosis and small fibre neuropathy

M Bakkers  1 , C G Faber, M Drent, M C E Hermans, S I van Nes, G Lauria, M De Baets, I S J Merkies
Affiliations

Pain and autonomic dysfunction in patients with sarcoidosis and small fibre neuropathy

M Bakkers et al. J Neurol. 2010 Dec.

Abstract

Small fibre neuropathy (SFN) has been demonstrated in sarcoidosis. However, a systematic analysis of neuropathic pain and autonomic symptoms, key features of SFN, has not been performed. Clinimetric evaluation of pain and autonomic symptoms using the neuropathic pain scale (NPS) and the modified Composite Autonomic Symptoms Scale (mCOMPASS) was used in sarcoidosis patients for this study. A total of 91 sarcoidosis patients (n = 23 without SFN symptoms, n = 43 with SFN symptoms but normal intraepidermal nerve fibre density (IENFD), n = 25 with SFN symptoms and reduced IENFD) were examined. NPS and mCOMPASS were assessed twice (reliability studies). Severity of pain was compared between the subgroups. Correlation between NPS and a visual analogue pain scale (VAS) was assessed (validity studies). Healthy controls (n = 105) completed the mCOMPASS for comparison with patients' scores. Patients with sarcoidosis, SFN complaints, and reduced IENFD demonstrated more severe pain scores on the NPS. The mCOMPASS differentiated between subjects with and without SFN symptoms. A significant correlation was obtained between the NPS and VAS, indicating good construct validity. Good reliability values were obtained for all scales. The use of the NPS to evaluate SFN symptoms is suggested, as it shows differences between patients with SFN symptoms with normal or reduced IENFD values. The mCOMPASS might be used to select patients for further testing.

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Figures

Fig. 1
Fig. 1
Graphical representation of several items of the neuropathic pain scale (NPS) in patients with sarcoidosis, those pain qualities with significant differences between subgroups are shown (p ≤ 0.04). Bars show percentage of patients in the three patient groups with (in blue) no, (red) minor to moderate or (green) severe pain. Group A, sarcoidosis patients without small fibre neuropathy (SFN) symptoms. Group B, sarcoidosis patients with SFN symptoms, but normal intraepidermal nerve fibre density (IENFD). Group C, sarcoidosis patients with SFN symptoms and impaired IENFD
Fig. 2
Fig. 2
Box plots showing median and interquartile ranges of the modified version of the Composite Autonomic Symptoms Scale (mCOMPASS) sum scores for healthy controls and various subgroups of patients with sarcoidosis. Comparison of subgroups by one way Anova + Bonferonni corrections. Group A (n = 23), patients without small fibre neuropathy (SFN) symptoms. Group B (n = 43), patients with SFN symptoms and normal intraepidermal nerve fibre density (IENFD). Group C (n = 25), patients with SFN symptoms and reduced IENFD. Between groups B and C, differences were not significant
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References

    1. Hoitsma E, Reulen JP, de Baets M, Drent M, Spaans F, Faber CG. Small fiber neuropathy: a common and important clinical disorder. J Neurol Sci. 2004;227:119–130. doi: 10.1016/j.jns.2004.08.012. - DOI - PubMed
    1. Iannuzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med. 2007;357:2153–2165. doi: 10.1056/NEJMra071714. - DOI - PubMed
    1. Hoitsma E, De Vries J, van Santen-Hoeufft M, Faber CG, Drent M. Impact of pain in a Dutch sarcoidosis patient population. Sarcoidosis Vasc Diffuse lung Dis. 2003;20:33–39. - PubMed
    1. Hoitsma E, Marziniak M, Faber CG, Reulen JP, Sommer C, De Baets M, Drent M. Small fiber neuropathy in sarcoidosis. Lancet. 2002;359:2085–2086. doi: 10.1016/S0140-6736(02)08912-2. - DOI - PubMed
    1. Hunninghake GW, Costabel U, Ando M, Baughman R, Cordier JF, du Bois R, Eklund A, Kitaichi M, Lynch J, Rizzato G, Rose C, selroos O, Semenzato G, Sharma OP. ATS/ERS/WASOG statement on sarcoidosis American Thoracic society/European Respiratory Society/world Association of Sarcoidosis and other Granulomatous Disorders. Sarcoidosis Vasc Diffuse Lung Dis. 1999;16:149–173. - PubMed

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