The utility of nerve biopsy in carefully selected patients in modern neuromuscular practice

Berini, Sarah E.; Dyck, Peter J.

doi:10.1002/mus.26479

Cited by 7 publications

(4 citation statements)

References 12 publications

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“…In an editorial published by Berini et al [ 29 ] in 2019, the authors opine that nerve biopsy continues to be a useful diagnostic tool in diseases such as amyloid neuropathy, peripheral nerve sheath tumors, perineurioma, metastatic disease to nerve or neurolymphomatosis, inflammatory disorders (sarcoidosis or inflammatory demyelination such as atypical CIDP) and nerve vasculitis, where nerve biopsy continues to be the “gold standard” investigation.…”

Section: Resultsmentioning

confidence: 99%

Relevance of Nerve Biopsy in the Diagnosis of Chronic Inflammatory Demyelinating Polyneuropathy—A Systematic Review

et al. 2022

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Chronic Inflammatory Demyelinating Polyneuropathy is an immune-mediated pathology of the peripheral nerves and nerve roots that leads to weakness and sensory symptoms. Given its clinical heterogeneity, often times diagnosis is challenging. Even though nerve conduction studies and clinical features are the main criteria used for diagnosis, supplementary investigations, such as nerve biopsies, cerebral spinal fluid examination and magnetic resonance studies, may be used in order to confirm the diagnosis. Given the fact that the hallmark in CIDP physiopathology is the demyelination process, nerve biopsies are used to demonstrate and assess the magnitude of the phenomenon. The question and the main interest of this review is whether histopathological findings are relevant for the diagnosis and can be useful in disease assessment.

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Section: Resultsmentioning

confidence: 99%

Relevance of Nerve Biopsy in the Diagnosis of Chronic Inflammatory Demyelinating Polyneuropathy—A Systematic Review

et al. 2022

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“…Tissue biopsy remains the standard for diagnostic confirmation in most vasculitis cases. 17 Unfortunately, nerve biopsy is not readily available in Brazil. In patients with polyarteritis-nodosa-like in HIV infection, corticosteroid response is good with an excellent prognosis, as in the case presented herein.…”

Section: Discussionmentioning

confidence: 99%

A great simulator in clinical practice: mononeuritis multiplex in HIV infection

Baima,

Silva,

Vieira

et al. 2024

Autops Case Rep

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HIV infection is a chameleon, mimicking several diseases. Herein, we report a previously healthy 39-year-old woman who, over 2 months, developed arthritis, weight loss, and confluent multiple mononeuropathy. Extensive laboratory investigation showed positive serology for HIV, with a CD4 count of 100 cells, and necrotizing vasculitis on a nerve biopsy not associated with CMV co-infection, allowing the diagnosis of polyarteritis nodosa-like vasculitis in an HIV-infected patient. Apart from the infection, HIV-related autoimmunity can affect any organ and contribute to the complexity of the clinical presentation of HIV infection.

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“…Targeted fascicular biopsy should be considered in rapidly progressive neuropathies with electrophysiologic or radiographic evidence of disease. 8 PET CT showed moderate brachial plexus hypermetabolism. MRI of the brachial plexus was obtained to assist in biopsy planning, which demonstrated T2-hyperintense enlargement of both plexi with peripheral enhancement (figure 2, B and C).…”

Section: Sectionmentioning

confidence: 97%

Clinical Reasoning: Multifocal neuropathies in a patient with Waldenstrom macroglobulinemia and prior borreliosis

et al. 2020

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A 77-year-old man presented with 1 week of back pain, night sweats, confusion, jaundice, and pruritus with patchy, blanchable erythematous lesions over his trunk (figure 1). Neurologic examination was normal, but a lumbar spine MRI showed diminished bone marrow signal. He was thrombocytopenic (13 × 10 9 /L) and anemic (7.2 g/dL) with an immunoglobulin M (IgM) kappa monoclonal gammopathy and bone marrow biopsy consistent with Waldenstrom macroglobulinemia (WM). He was initiated on 60 mg prednisone daily and rituximab. Skin biopsy revealed nonspecific dermal edema with perivascular inflammation. Two weeks into admission, he developed left lower motor neuron facial droop, and was kept on the prednisone started 2 days prior for his WM. Shortly after that, it was noted that his Borrelia burgdorferi enzyme immunoassay (EIA) screen and supplemental B burgdorferi IgM immunoblot were positive, while the immunoglobulin G immunoblot was negative. Three weeks later, his facial palsy had resolved, but given extensive tick exposure history, he was treated with 3 weeks of doxycycline. CSF collection was deferred due to thrombocytopenia. Nine months later, the patient presented to neurology with 3 weeks of progressive left ptosis, bilateral upper extremity weakness, and neuropathic pain in a C5 distribution. MRI head and cervical spine were unremarkable. CSF showed a mildly elevated protein of 65 mg/dL with normal cell count and glucose, 7 unique oligoclonal bands, and negative cytology. Because of the prior Lyme disease (LD), an LD CSF antibody index (AI) was performed, which was elevated at Figure 1 Multifocal, blanchable, erythematous patches over the trunk, some with a dusky center From the Departments of Neurology (B.

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The utility of nerve biopsy in carefully selected patients in modern neuromuscular practice

Abstract: https://onlinelibrary.wiley.com/doi/10.1002/mus.26431/full.

Cited by 7 publications

References 12 publications

Relevance of Nerve Biopsy in the Diagnosis of Chronic Inflammatory Demyelinating Polyneuropathy—A Systematic Review

Relevance of Nerve Biopsy in the Diagnosis of Chronic Inflammatory Demyelinating Polyneuropathy—A Systematic Review

A great simulator in clinical practice: mononeuritis multiplex in HIV infection

Clinical Reasoning: Multifocal neuropathies in a patient with Waldenstrom macroglobulinemia and prior borreliosis

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