Endoneurial edema in sural nerve may indicate recent onset inflammatory neuropathy

Muscle Nerve. 2016 May;53(5):705-10. doi: 10.1002/mus.24930. Epub 2016 Jan 27.

Abstract

Introduction: Sural nerve biopsy is an important means of establishing the diagnosis of inflammatory neuropathies. We investigated the diagnostic value of endoneurial edema.

Methods: Diagnostic sural nerve biopsies from 42 patients with inflammatory and 28 patients with noninflammatory neuropathies were re-evaluated for the presence of endoneurial edema. Edema was assessed on hematoxylin-eosin stained paraffin and frozen sections and on azure II-methylene blue stained semithin sections. We determined the area of endoneurial edema on digitized images in relation to the entire endoneurial area of each fascicle.

Results: Edema was more extensive in neuropathies with short disease duration (≤12 months) as compared to long duration (>12 months; P < 0.01). Edema in inflammatory neuropathies of ≤12 months duration covered a larger area than in noninflammatory neuropathies (P < 0.01), and the extent of edema correlated negatively with disease duration (P < 0.05).

Conclusions: Endoneurial edema may be a useful additional disease marker in inflammatory neuropathies of recent onset.

Keywords: diagnosis; endoneurial edema; histology; inflammatory neuropathy; noninflammatory neuropathy; polyneuropathy; sural nerve biopsy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Amyotrophic Lateral Sclerosis / complications
  • Amyotrophic Lateral Sclerosis / immunology
  • Amyotrophic Lateral Sclerosis / pathology
  • Biopsy
  • Case-Control Studies
  • Diabetic Neuropathies / complications
  • Diabetic Neuropathies / immunology
  • Diabetic Neuropathies / pathology
  • Edema / etiology
  • Edema / immunology
  • Edema / pathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscular Atrophy, Spinal / complications
  • Muscular Atrophy, Spinal / immunology
  • Muscular Atrophy, Spinal / pathology
  • Paraneoplastic Polyneuropathy / complications
  • Paraneoplastic Polyneuropathy / immunology
  • Paraneoplastic Polyneuropathy / pathology
  • Peripheral Nerves / immunology
  • Peripheral Nerves / pathology
  • Peripheral Nervous System Diseases / complications
  • Peripheral Nervous System Diseases / immunology
  • Peripheral Nervous System Diseases / pathology*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / complications
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / immunology
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / pathology
  • Sural Nerve / immunology
  • Sural Nerve / pathology*