Abstract：
OBJECTIVE:Small fiber neuropathy commonly affects patients with sarcoidosis and is often refractory to standard immunosuppressive therapies used for systemic disease. The clinical features of sarcoidosis-associated small fiber neuropathy (SSFN) and its response to medical therapy have not been described in a large population. METHODS:We performed a retrospective review of patients with SSFN seen at the Cleveland Clinic over a 4-year period. RESULTS:SSFN was identified in 143 individuals although other causes of neuropathy were found in 28 cases. Of the remaining 115 patients, 100 (87%) were Caucasian and 72 (63%) were female. Median age at reported neuropathy onset was 46 years (range 19-77 years), while median age of systemic diagnosis was 41 years. Pain and paresthesias were the most common symptoms, of which 54% were nonlength-dependent. Dysautonomia was seen in 61 patients with cardiac symptoms (orthostasis, palpitations) as the most common presentation followed by gastrointestinal and sweating dysfunction. Symptomatic improvement with treatment was seen in 47 of 62 patients that received IVIG, 8 of 12 patients that received anti-TNF and 10 of 14 patients who received combination therapy. Of 27 patients who were untreated, 4 improved. CONCLUSIONS:The most common presentation of SSFN in our series was a painful non-length dependent polyneuropathy with the highest overall incidence in Caucasian females. In most patients, neuropathy symptoms developed within 3 years of systemic sarcoidosis diagnosis. IVIG appeared beneficial in treating SSFN symptoms while nearly 2/3 of subjects also responded favorably to anti-TNF with or without IVIG. Further prospective studies are needed.
journal_name
Respir Medjournal_title
Respiratory medicineauthors
Tavee JO,Karwa K,Ahmed Z,Thompson N,Parambil J,Culver DAdoi
10.1016/j.rmed.2017.03.011subject
Has Abstractpub_date
2017-05-01 00:00:00pages
135-138eissn
0954-6111issn
1532-3064pii
S0954-6111(17)30067-7journal_volume
126pub_type
杂志文章abstract：AIM:To assess the role of doctors who patients report as responsible of their disease, in moderate-severe chronic obstructive pulmonary disease (COPD), describing characteristics of patients and treatments use according to each type of doctor, and relating it to the way of access to hospital at the time of an exacerbat...
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pub_type： 临床试验,杂志文章
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pub_type： 杂志文章,评审
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