Pain and autonomic dysfunction in patients with sarcoidosis and small fibre neuropathy |
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Authors: | M Bakkers C G Faber M Drent M C E Hermans S I van Nes G Lauria M De Baets I S J Merkies |
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Institution: | (1) Department of Neurology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands;(2) Department of Respiratory Medicine, Interstitial Lung Disease Care Team, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands;(3) Department of Neurology, Erasmus Medical Centre Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands;(4) Neuromuscular Diseases Unit, IRCCS Foundation, National Neurological Institute “Carlo Besta”, via Celoria 11, 20133 Milan, Italy;(5) Department of Neuroscience, School for Mental Health and Neuroscience, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands;(6) Department of Neurology, Spaarne Hospital, Spaarnepoort 1, 2134 TM Hoofddorp, The Netherlands |
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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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