PMID- 18346234
OWN - NLM
STAT- MEDLINE
DCOM- 20080610
LR  - 20080318
IS  - 1529-8027 (Electronic)
IS  - 1085-9489 (Linking)
VI  - 13
IP  - 1
DP  - 2008 Mar
TI  - Diagnostic value of sural nerve biopsy in patients with suspected Borrelia 
      neuropathy.
PG  - 81-91
LID - 10.1111/j.1529-8027.2008.00161.x [doi]
AB  - Peripheral neuropathy is a recognized but incompletely understood manifestation 
      of borreliosis. As the pathology of this neuropathy has been described only in 
      small case series, the value of nerve biopsy findings for the pathologic 
      diagnosis of Borrelia-associated neuropathy is unclear. We collected and 
      investigated 21 patients with peripheral neuropathy and with typical clinical and 
      serologic signs of neuroborreliosis [Borrelia neuropathy (BN)]. Standard 
      histology and immunohistochemistry were performed on sural nerve biopsies using 
      antibodies to CD4, CD68 and membrane attack complex C5b-9, intercellular adhesion 
      molecule (ICAM)-1, tumor necrosis factor (TNF)-alpha, interleukin (IL)-1, and 
      IL-6. Nine patients with idiopathic vasculitic neuropathy (VN) and 14 with 
      idiopathic axonal neuropathy (AN) served as disease controls. In BN, the 
      characteristic histology was that of an AN with transmural or perivascular 
      lymphocytic infiltration of nerve vessels. In BN, but less in VN and AN, 
      perineurial thickening and neovascularization were observed. For BN but not for 
      VN, this thickening correlated with increased perineurial immunoreactivity (IR) 
      to TNF-alpha, C5b-9, and ICAM-1. In comparison to AN, both BN and VN displayed 
      increased perineurial T-cell infiltration and human leukocyte antigen 
      (HLA)-DR3-IR. In the endoneurium, cytokine (IL-1beta, IL-6, TNF-alpha), HLA-DR3, 
      and ICAM-1 expression was more pronounced in VN but not in BN. The neuropathy in 
      patients with neuroborreliosis resembles idiopathic VN but shows some distinctive 
      features. None of the findings of this study are disease specific but as a 
      pattern may help support the diagnosis of inflammatory neuropathy in patients 
      with serological evidence for Borrelia infection.
FAU - Schafers, Maria
AU  - Schafers M
AD  - Department of Neurology, University of Wurzburg, Wurzburg, Germany.
FAU - Neukirchen, Sebastian
AU  - Neukirchen S
FAU - Toyka, Klaus V
AU  - Toyka KV
FAU - Sommer, Claudia
AU  - Sommer C
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Peripher Nerv Syst
JT  - Journal of the peripheral nervous system : JPNS
JID - 9704532
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biopsy
MH  - *Borrelia
MH  - Borrelia Infections/*diagnosis/pathology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Peripheral Nervous System Diseases/*diagnosis/pathology
MH  - Retrospective Studies
MH  - Sural Nerve/*pathology
EDAT- 2008/03/19 09:00
MHDA- 2008/06/11 09:00
CRDT- 2008/03/19 09:00
PHST- 2008/03/19 09:00 [pubmed]
PHST- 2008/06/11 09:00 [medline]
PHST- 2008/03/19 09:00 [entrez]
AID - JNS161 [pii]
AID - 10.1111/j.1529-8027.2008.00161.x [doi]
PST - ppublish
SO  - J Peripher Nerv Syst. 2008 Mar;13(1):81-91. doi: 
      10.1111/j.1529-8027.2008.00161.x.