Activate Now
ProHealth fibromyalgia Vitamin and Natural Supplement Store and Health
Home  |  Log In  |  My Account  |  View Cart  View Your ProHealth Vitamin and Supplement Shopping Cart
800-366-6056  |  Contact Us  |  Help
Facebook Google Plus
Fibromyalgia  Chronic Fatigue Syndrome & M.E.  Lyme Disease  Natural Wellness  Supplement News  Forums  Our Story
Store     Brands   |   A-Z Index   |   Best Sellers   |   New Products   |   Deals & Specials   |   Under $10   |   SmartSavings Club

Trending News

Aromatherapy Diffusers For Fibromyalgia Support

Chronic Fatigue Syndrome, Fibromyalgia and Mitchondrial Disorders: A Comparison Plus the MitoQ Trial...

Dr. Teitelbaum's 3 Steps to Fibromyalgia Pain Relief - Part 1: Understanding Fibromyalgia Pain

An Interview with Ken McKim: Educating the public about chronic illness

Repair Damaged Mitochondria and Reduce Fatigue Up to 45%

Milnacipran for pain in fibromyalgia in adults

Are All the "Feel-Good" Pathways Blocked in Fibromyalgia and Chronic Fatigue Syndrome?

5 Things I've Learned About Chronic Illness Through Mindfulness

SURVEY RESULTS: Has Your Illness Affected What You Eat?

Staying healthy from fibromyalgia is ongoing hard work

Print Page
Email Article

Abnormal Epidermal Nerve Fiber Density in Fibromyalgia

  [ 7 votes ]   [ Discuss This Article ] • April 14, 2014

Evidence of abnormal epidermal nerve fiber density in fibromyalgia: Clinical and immunologic implications.

By Xavier J. Caro and Earl F. Winter


Objective: A subset of fibromyalgia (FM) patients exhibits a large fiber, demyelinating peripheral polyneuropathy, akin to that seen in chronic inflammatory demyelinating polyneuropathy (CIDP). It has been suggested that this demyelinating process is likely to be immune mediated. Since it is known that similar, large fiber neuropathic lesions may be associated with a cutaneous small fiber neuropathy (SFN), we sought to determine the prevalence of SFN, as measured by epidermal nerve fiber density (ENFD), in a series of FM patients and clinically healthy controls.

Methods: Forty-one consecutive FM and 47 control subjects underwent a 3 mm punch skin biopsy at the proximal thigh and distal leg near the ankle for ENFD analysis. FM subjects with clinical evidence of a disorder known to be associated with SFN were excluded. FM subjects also underwent clinical study for stocking distribution hypesthesia by pinwheel and vibratory testing, and serologic investigation of a series of cytokine, CIC, and complement measurements.

Results: All FM subjects had evidence of stocking distribution hypesthesia.
  • The mean ENFD for FM subjects was lower than for controls at both the calf (5.8 ± 2.8 SD vs. 7.4 ± 1.9 SD; P < 0.0002) and thigh (9.3 ± 3.2 SD vs. 11.3 ± 2.0 SD; P < 0.0007).

  • There was an inverse correlation between calf ENFD and age, at the time of skin biopsy, in FM subjects (r = - 0.29; P = 0.03), but not in controls. ANCOVA showed that this relationship could not be explained by aging alone, however.

  • Serologic evaluation showed an inverse correlation between calf ENFD in FM subjects and the T-cell/macrophage activation marker, IL-2R (r = - 0.28; P = 0.04).

  • Correlation analysis of thigh ENFD and serum IL-2R did not reach significance (P = 0.08).

  • Analysis of calf/thigh ENFD ratios suggests that ENFD decline in FM is affected by both a diffuse, and a length dependent, process

Conclusion: Calf and thigh ENFD in FM are significantly diminished compared to controls. Advancing age, alone, can not explain this finding. Calf ENFD correlated, though weakly, in an inverse fashion with serum IL-2R (P = 0.04). These findings suggest that SFN is likely to contribute to FM pain complaints; that pain in this disorder arises, in part, from a peripheral immune mediated process; and that measurement of ENFD may be a useful clinical tool in FM.

Copyright © 2014 American College of Rheumatology.

Source: Arthritis & Rheumatology, April 9, 2014. By Xavier J. Caro and Earl F. Winter. Northridge Hospital Medical Center, Professional Building, 18350 Roscoe Boulevard, Suite 418, Northridge, CA, 91325.

Post a Comment

Featured Products From the ProHealth Store
Optimized Curcumin Longvida® B-12 Extreme™ Hydroxocobalamin Extreme™

Looking for Vitamins, Herbs and Supplements?
Search the ProHealth Store for Hundreds of Natural Health Products

Article Comments

Be the first to comment on this article!

Post a Comment

Free Chronic Fatigue Syndrome and Fibromyalgia Newsletters
Subscribe to
Subscribe Now!
Receive up-to-date ME/CFS, Fibromyalgia & Lyme Disease treatment and research news
 Privacy Guaranteed  |  View Archives

Repair Damaged Mitochondria and Reduce Fatigue Up to 45%

Featured Products

B-12 Extreme™ B-12 Extreme™
The Most Potent Vitamin B-12 on Earth
Optimized Curcumin Longvida® Optimized Curcumin Longvida®
Supports Cognition, Memory & Overall Health
Fibro Freedom™ Fibro Freedom™
Soothes, strengthens & revitalizes
Guaifenesin FA™ Guaifenesin FA™
Helps the Body Eliminate Excess Calcium and Phosphates
Hydroxocobalamin Extreme™ Hydroxocobalamin Extreme™
The B-12 your brain needs for detox & sharpness

Natural Remedies

Block Acid Reflux to Prevent Esophageal Problems! Block Acid Reflux to Prevent Esophageal Problems!
Can Glycine + Amino Acids Be the Secret to Deep, Rejuvenating Sleep? Can Glycine + Amino Acids Be the Secret to Deep, Rejuvenating Sleep?
Strontium - The Missing Mineral for Strong Bones Strontium - The Missing Mineral for Strong Bones
The Most Powerful Natural Antioxidant Discovered to Date - Hydroxytyrosol The Most Powerful Natural Antioxidant Discovered to Date - Hydroxytyrosol
Optimize Your Immune System Naturally: Thymic Protein A Optimize Your Immune System Naturally: Thymic Protein A

What is Fibromyalgia?
Fibromyalgia Diagnosis
Fibromyalgia Symptoms
Fibromyalgia Causes
Fibromyalgia Treatments
Fibromyalgia Diet
Fibromyalgia Medications
M.E. & CFS
What is M.E./CFS?
M.E./CFS Diagnosis
M.E./CFS Symptoms
M.E./CFS Causes
M.E./CFS Treatments
M.E./CFS Diet
M.E./CFS Medications
What is Lyme Disease?
Lyme Disease Diagnosis
Lyme Disease Symptoms
Lyme Disease Causes
Lyme Disease Treatments
Lyme Disease Diet
Lyme Disease Medications
M.E. & CFS
Lyme Disease
General Health
ProHealth on Facebook  ProHealth on Twitter  ProHealth on Pinterest  ProHealth on Google Plus
Credit Card Processing