Cutaneous sarcoidosis small-fiber neuropathy resembling leprosy

Napolitano, Maddalena; Patruno, Cataldo; D’Andrea, Mirella; Ferrillo, Maria; Megna, Matteo; Fabbrocini, Gabriella; Campora, Michela; Barabino, Gianfranco; Forgione, Patrizia

doi:10.23736/s2784-8671.20.06620-1

Cited by 2 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Genetic SFN is because of mutations in a number of genes, such as GLA (Fabry disease), TTR (transthyretin-related amyloidosis), or SNCA (alpha-synucleinopathy) and many others. Secondary causes of SFN prevail and include, for example, diabetes, renal failure, thyroid dysfunction, hypovitaminoses, acute infections (SARS-CoV-2,[ 8 ] borreliosis[ 9 ]), vaccinations (rabies, varicella, human papillomavirus, lyme, SARS-CoV-2),[ 8 10 ] auto-immune disease,[ 11 12 ] pure autonomic failure because of alpha-synuclein deposition,[ 13 ] sarcoidosis,[ 14 ] Sjögren syndrome,[ 15 ] Parkinson’s disease,[ 16 ] and many others. [ 17 ] SFN may go along with or without affection of large motor or sensory fibers.…”

Section: Discussionmentioning

confidence: 99%

Small fiber neuropathy as a complication of SARS-CoV-2 vaccinations

Finsterer

2022

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

Generally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations are not free of side effects. A rarely reported adverse reaction to SARS-CoV-2 vaccinations is small fiber neuropathy (SFN). Here, we present three patients with SFN after the second dose of messenger ribonucleic acid-based SARS-CoV-2 vaccines. Data for this study were collected via the self-made platform “Pubbly” for reporting side effects of SARS-CoV-2 vaccinations. Three patients with post-SARS-CoV-2 vaccination SFN were identified: a 40 yo Caucasian female (patient 1), a 52 yo Caucasian female (patient 2), and a 32 yo Caucasian female (patient 3). Patient 1 complained about fatigue, dizziness, flushing, palpitations, diarrhea, muscle weakness, and gait disturbance 10 days after the second Pfizer jab. Patient 2 reported dizziness, balance problems, brain fog, palpitations, dysphagia, and sleep problems. Patient 3 complained about profound fatigue, brain fog, vertigo, pre-syncopal sensations, hair loss, chest pain, dyspnea, palpitations, paresthesias, irregular menstrual cycles, muscle weakness, and hives 1 day after the second Moderna dose. All three patients underwent skin biopsy upon which SFN was diagnosed. Patient 1 profited from immunoglobulins, but patient 2 did not require any treatment. Symptoms in patient 3 resolved upon symptomatic treatment. Despite treatment, patient 1 did not completely recover. SFN can be a rare side effect of SARS-CoV-2 vaccinations. Post-SARS-CoV-2 vaccination SFN can be mild or severe and may or may not require treatment. Post-SARS-CoV-2 vaccination SFN is most likely immune-mediated as it responds to intravenous immunoglobulins.

show abstract

Section: Discussionmentioning

confidence: 99%

Small fiber neuropathy as a complication of SARS-CoV-2 vaccinations

Finsterer

2022

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

show abstract

“…13,26 Toxins are known to cause SFN include alcohol, heavy metals (e.g., mercury), 27 platinumbased agents, taxanes, remdesivir, immune checkpoint inhibitors, 28 proteasome-inhibitors (e.g., bortezomib), N-hexane, resiniferatoxin, pyridoxine, nitrofurantoin, metronidazole, and several others. Autoimmune disease manifesting with SFN include monoclonal gammopathy; sarcoidosis, 24,29,30 rheumatic disease (mixed connective tissue disease, systemic vasculitis), 8,31,32 Sjögren syndrome, 33 anti-plexin D1-IgG antibodies in mice, 34 Behcet disease, 35 familial Mediterranean fever, 35 celiac disease, 36 primary systemic vasculitis, Guillain-Barre syndrome (GBS), chronic, inflammatory, demyelinating polyneuropathy (CIDP), lupus, AA, and AL amyloidosis, which can be associated with familial Mediterranean fever and hyperlipidemia, and acute, inflammatory SFN. 21 Neoplasms associated with SFN include keloids, 37 lymphoma, carcinoid, 18 and others.…”

Section: Secondary Sfnmentioning

confidence: 99%

Small fiber neuropathy

Finsterer

Scorza

2022

Acta Neuro Scandinavica

View full text Add to dashboard Cite

Small fiber neuropathy (SFN) is a peripheral nervous system disease due to affection of A‐delta or C‐fibers in a proximal, distal, or diffuse distribution. Selective SFN (without large fiber affection) manifests with pain, sensory disturbances, or autonomic dysfunction. Though uniform diagnostic criteria are unavailable, most of them request typical clinical features and reduced intra‐epidermal nerve fiber density on proximal or distal skin biopsy. Little consensus has been reached about the treatment of SFN, why this narrative review aims at summarizing and discussing treatment options for SFN. Treatment of SFN can be classified as symptomatic, pathophysiologic, or causal. Prerequisites for treating SFN are an established diagnosis, knowledge about the symptoms and signs, and the etiology. Pain usually responds to oral/intravenous pain killers, antidepressants, anti‐seizure drugs, or topical, transdermal specifications. Some of the autonomic disturbances respond favorably to symptomatic treatment. SFN related to Fabry disease or hATTR are accessible to pathogenesis‐related therapy. Immune‐mediated SFN responds to immunosuppression or immune‐modulation. Several of the secondary SFNs respond to causal treatment of the underlying disorder. In conclusion, treatment of SFN relies on a multimodal concept and includes causative, pathophysiologic, and symptomatic measures. It strongly depends on the clinical presentation, diagnosis, and etiology, why it is crucial before initiation of treatment to fix the diagnosis and etiology. Due to the heterogeneous clinical presentation and multi‐causality, treatment of SFN should be individualized with the goal of controlling the underlying cause, alleviating pain, and optimizing functionality.

show abstract

Cutaneous sarcoidosis small-fiber neuropathy resembling leprosy

Cited by 2 publications

References 5 publications

Small fiber neuropathy as a complication of SARS-CoV-2 vaccinations

Small fiber neuropathy as a complication of SARS-CoV-2 vaccinations

Small fiber neuropathy

Contact Info

Product

Resources

About