Clinical and pathological assessment of Peripheral neuropathy in pulmonary sarcoidosis
Main Article Content
Keywords
Peripheral neuropathy, sarcoidosis, steroid, hypoxia, High resolution computed tomography (HRCT)
Abstract
Background: Sarcoidosis is a multifactorial disorder of unfamiliar origin characterized by noncaseating granulomas in different body parts .The purpose of this investigation was to study the association of neuropathy in patients with pulmonary sarcoidosis
Methods: The study included 30 patients with pulmonary sarcoidosis on systemic steroid with hypoxia, 30 patients with pulmonary sarcoidosis on systemic steroid without hypoxia and 30 patients with pulmonary sarcoidosis and not on steroid without hypoxia. Clinical, neurophysiological, laboratory, radiological and histopathological assessment was done for them.
Results: LANSS pain scale was significantly associated with the neuropathic on systemic steroids contributions group when compared to the neuropathic without steroids group. The TCNS's univariate linear regression analysis revealed statistically significant correlations between clinical, electrophysiological, and disability indicators. The mean serum levels of il-2R and ACE were greater in
the sick group than in the control group (193.93 ± 56.4, 202.46 ± 351.78 for patient group and 29.1 ±8.498884, 78.526667 ± 63.995829 in control group respectively).
Conclusion: There was significant positive correlation in severity of neuropathy and degree of hypoxia and there were statistically
significant difference between severity of neuropathy and dose of steroids in both the Initial dosage and 3- month evaluation of response.
References
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Neurology, 2020. 26(5): p. 1257-1279.
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neuropathy. 2022.
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8. Chkheidze, R. and P. Pytel, What every neuropathologist needs to know: Peripheral nerve biopsy. Journal of Neuropathology & Experimental
Neurology, 2020. 79(4): p. 355-364.
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2048-2052.
16. Bril, V., et al., Reliability and validity of the modified Toronto Clinical Neuropathy Score in diabetic sensorimotor polyneuropathy. Diabetic
Medicine, 2009. 26(3): p. 240-246.
17. Said, G., et al., Nerve granulomas and vasculitis in sarcoid peripheral neuropathy: a clinicopathological study of 11 patients. Brain,
2002. 125(2): p. 264-275.
18. Ishihara, M., et al., Usefulness of Combined Measurement of Serum Soluble IL-2R and Angiotensin-Converting Enzyme in the Detection
of Uveitis Associated with Japanese Sarcoidosis.Clinical Ophthalmology (Auckland, NZ), 2020. 14: p. 2311.
19. Abraham, A., et al., Toronto Clinical Neuropathy Score is valid for a wide spectrum of polyneuropathies. European Journal of Neurology,
2018. 25(3): p. 484-490.
20. El Sissi, W., et al., Prevalence of neuropathic pain among patients with chronic low-back pain in the Arabian Gulf Region assessed using the leeds assessment of neuropathic symptoms and signs pain scale. Journal of International Medical Research, 2010. 38(6): p. 2135-2145.
21. Bennett, M., The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs.Pain, 2001. 92(1-2): p. 147-157.
22. Kaki, A.M., A.Z. El-Yaski, and E. Youseif, Identifying neuropathic pain among patients with chronic low-back pain: use of the Leeds
Assessment of Neuropathic Symptoms and Signs pain scale. Regional Anesthesia & Pain Medicine, 2005. 30(5): p. 1-422.
23. Zilliox, L.A., et al., Clinical neuropathy scales in neuropathy associated with impaired glucose tolerance. Journal of diabetes and its
complications, 2015. 29(3): p. 372-377.
24. Avci, A.Y. and S. Avci, Peripheral Nerve Function Changes Due to Hypoxia in ObstructiveSleep Apnea. 2019.
25. Lüdemann, P., et al., Axonal polyneuropathy in obstructive sleep apnoea. Journal of Neurology, Neurosurgery & Psychiatry, 2001. 70(5): p. 685-687.
26. Mayer, P., et al., Peripheral neuropathy in sleep apnea: a tissue marker of the severity of nocturnal desaturation. American Journal of Respiratory and Critical Care Medicine, 1999. 159(1): p. 213-219.
27. Mihalj, M., L. Lušić, and Z. Đogaš, Reduced evoked motor and sensory potential amplitudes in obstructive sleep apnea patients. Journal of SleepResearch, 2016. 25(3): p. 287-295.
28. Tapan, Ö.O., U. Tapan, and Ü.S. Kılıç, Obstrüktif Uyku Apne Sendromlu Hastalarda Hipoksinin Göz Üzerine Etkileri. Journal of Turkish Sleep
Medicine, 2016. 2: p. 43-47.
29. Vila, A., et al., Neuropathies and chronic respiratory insufficiency: electrophysiologic study.Revue D'electroencephalographie et de
Neurophysiologie Clinique, 1986. 15(4): p. 331-340.
30. Dziewas, R., et al., Treatment for obstructive sleep apnoea: effect on peripheral nerve function.Journal of Neurology, Neurosurgery & Psychiatry, 2007. 78(3): p. 295-297.
31. EVLİCE, A., et al., Obstruktif Uyku Apne Sendromunda Nöropati ve Disotonomi Neuropathy and Dysautonomia in Patients with Obstructive
Sleep Apnea. 2015.
32. Sforza, E. and F. Roche, Chronic intermittent hypoxia and obstructive sleep apnea: an experimental and clinical approach. Hypoxia,
2016. 4: p. 99.
33. Song, D., et al., Chronic intermittent hypoxia exposure-induced atherosclerosis: a brief review.Immunologic research, 2015. 63(1): p. 121-130.
34. Deng, F., et al., Endothelial microvesicles in hypoxic hypoxia diseases. Journal of cellular and molecular medicine, 2018. 22(8): p. 3708-3718.
35. Kayacan, O., et al., Neurophysiological changes in COPD patients with chronic respiratory insufficiency. Acta neurologica belgica, 2001.
101(3): p. 160-165.
36. Frolkis, V.V., S.A. Tanin, and Y.N. Gorban, Agerelated changes in axonal transport. Experimental gerontology, 1997. 32(4-5): p. 441-450.
37. Malik, R., et al., Hypoxic neuropathy: relevance to human diabetic neuropathy. Diabetologia, 1990. 33(5): p. 311-318.
38. Wang, Y., et al., Ischemia–reperfusion injury of peripheral nerve in experimental diabetic neuropathy. Journal of the neurological sciences,
2004. 227(1): p. 101-107.
39. Bondy, S.C. and C.P. LeBel, The relationshipbetween excitotoxicity and oxidative stress in the central nervous system. Free Radical Biology and Medicine, 1993. 14(6): p. 633-642.
40. Hampton, K., et al., Resistance to ischaemic conduction failure in chronic hypoxaemia and diabetes. Journal of Neurology, Neurosurgery &
Psychiatry, 1989. 52(11): p. 1303-1305.
41. Faisal, H. T. ., Abid, M. K. ., & Abed, A. . (2022). Study Of Some Biochemical Parameters in Dose During Pregnancy in Goats. Journal Of Advanced Zoology, 43(1), 01–06. https://doi.org/10.17762/jaz.v43i1.109
42. Gulati, H. ., & Rana, S. . (2022). Habitat Preference and Current Threats to The Sarus Cranes Grus Antigone (Aves: Gruiformes:
Gruidae) In Important Bird Areas of Haryana, India: Implications for Determining EffectiveConservation Actions. Journal Of Advanced Zoology, 43(1), 07–16. Retrieved from http://jazindia.com/index.php/jaz/article/view/110
43. Mokhtar, A. R. R. A. S. . (2022). Development Of Saponin Based Wettable Powder Formulation from Phaleria macrocarpa To Control Pomacea maculate. Journal Of Advanced Zoology, 43(1), 17–31. Retrieved from http://jazindia.com/index.php/jaz/article/view/111.
2. Castelli, G., K.M. Desai, and R.E. Cantone, Peripheral neuropathy: evaluation and differential diagnosis. American family physician, 2020.
102(12): p. 732-739.
3. Malik, R.A., et al., Diagnosing peripheral neuropathy in South‐East Asia: a focus on diabetic neuropathy. Journal of Diabetes Investigation,
2020. 11(5): p. 1097-1103.
4. Ginsberg, L., Vasculitis and the peripheral nervous system. Rheumatology, 2020. 59(Supplement_3): p. iii55-iii59.
5. Biswas, S. ., Bhagyasree, V. ., & Rathod, V. N. . (2022). A CHECKLIST OF BIRDS AND DIVERSITY OF AVIAN FAUNA IN MUDASARLOVA RESERVOIR OF VISAKHAPATNAM, INDIA . Journal Of Advanced Zoology, 42(02), 165–175. https://doi.org/10.17762/jaz.v42i02.51
6. Faisal, H. T. ., Abid, M. K. ., & Abed, A. . (2022). Study Of Some Biochemical Parameters in Dose During Pregnancy in Goats. Journal Of Advanced Zoology, 43(1), 01–06. https://doi.org/10.17762/jaz.v43i1.109
7. Wankhade, L. N. . (2022). STUDY ON BUTTERFLY FAUNA OF KARANJA (GHADGE) TAHSIL OF DISTRICT WARDHA
(MAHARASHTRA). Journal Of Advanced Zoology, 42(02), 186–193. https://doi.org/10.17762/jaz.v42i02.53
8. Petropoulos, I.N., et al., The utility of corneal nerve fractal dimension analysis in peripheral neuropathies of different etiology. Translational
vision science & technology, 2020. 9(9): p. 43-43.
2. Yamamoto, T., Subcutaneous sarcoidosis: a report of 13 cases and its association with extracutaneous sarcoidosis. Sarcoidosis, Vasculitis, and Diffuse Lung Diseases, 2020. 37(2): p. 242.
3. Starshinova, A., et al., Small Fiber Neuropathy in Pulmonary Sarcoidosis and Tuberculosis: Clinical and Histological Correlates. 2020.
4. Siao, P. and M. Kaku. A clinician's approach to peripheral neuropathy. in Seminars in neurology. 2019. Thieme Medical Publishers.
1. Karam, C., Peripheral neuropathies associated with vasculitis and autoimmune connective tissue disease. CONTINUUM: Lifelong Learning in
Neurology, 2020. 26(5): p. 1257-1279.
2. Tavee, J., Peripheral neuropathy in sarcoidosis.Journal of Neuroimmunology, 2022: p. 577864.
3. Nold, C.S. and K. Nozaki, Peripheral neuropathy: Clinical pearls for making the diagnosis. Journal of the American Academy of PAs, 2020. 33(1): p. 9-15.
4. MISRA, K.A., Identification of genetic variants contributing to pain-related symptoms in familial and sporadic patients affected by peripheral
neuropathy. 2022.
5. Telleman, J.A., et al., Ultrasound scanning in the diagnosis of peripheral neuropathies. Practical Neurology, 2021. 21(3): p. 186-195.
6. Nathani, D., et al., Nerve biopsy: Current indications and decision tools. Muscle & Nerve, 2021. 64(2): p. 125-139.
7. Kitaoji, T., et al., Sonographic nerve enlargement in a patient with sarcoidosis. Internal Medicine, 2021. 60(9): p. 1469-1473.
8. Chkheidze, R. and P. Pytel, What every neuropathologist needs to know: Peripheral nerve biopsy. Journal of Neuropathology & Experimental
Neurology, 2020. 79(4): p. 355-364.
9. Miwa, T., et al., Sarcoid neuropathy with conduction block showing nerve fascicle compression by perineurial granuloma formation.
Clinical Neurology and Neurosurgery, 2020. 196: p. 105962.
10. Kielb, S. and J. Lai, Systemic illnesses (diabetes mellitus, sarcoidosis, alcoholism, and porphyrias), in Essentials of the Adult Neurogenic Bladder. 2020, CRC Press. p. 44-49.
11. Lopez-Castillo, D., et al., Multiple Eruptive Pyogenic Granulomas on the Proximal Nail Folds Following Cast Immobilization: A Case Report
with Nail Unit Ultrasound Findings. Acta Dermato-Venereologica, 2020. 100(6): p. 1-2.
12. Odajiu, I., et al., Peripheral neuropathy: A neglected cause of disability in COPD–A narrative review. Respiratory Medicine, 2022: p. 106952.
13. Criado, E., et al., Pulmonary sarcoidosis: typical and atypical manifestations at high-resolution CT with pathologic correlation. Radiographics, 2010. 30(6): p. 1567-1586.
14. Perkins, B.A., et al., Simple screening tests for peripheral neuropathy in the diabetes clinic.Diabetes care, 2001. 24(2): p. 250-256.
15. Bril, V. and B.A. Perkins, Validation of the Toronto Clinical Scoring System for diabetic polyneuropathy. Diabetes care, 2002. 25(11): p.
2048-2052.
16. Bril, V., et al., Reliability and validity of the modified Toronto Clinical Neuropathy Score in diabetic sensorimotor polyneuropathy. Diabetic
Medicine, 2009. 26(3): p. 240-246.
17. Said, G., et al., Nerve granulomas and vasculitis in sarcoid peripheral neuropathy: a clinicopathological study of 11 patients. Brain,
2002. 125(2): p. 264-275.
18. Ishihara, M., et al., Usefulness of Combined Measurement of Serum Soluble IL-2R and Angiotensin-Converting Enzyme in the Detection
of Uveitis Associated with Japanese Sarcoidosis.Clinical Ophthalmology (Auckland, NZ), 2020. 14: p. 2311.
19. Abraham, A., et al., Toronto Clinical Neuropathy Score is valid for a wide spectrum of polyneuropathies. European Journal of Neurology,
2018. 25(3): p. 484-490.
20. El Sissi, W., et al., Prevalence of neuropathic pain among patients with chronic low-back pain in the Arabian Gulf Region assessed using the leeds assessment of neuropathic symptoms and signs pain scale. Journal of International Medical Research, 2010. 38(6): p. 2135-2145.
21. Bennett, M., The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs.Pain, 2001. 92(1-2): p. 147-157.
22. Kaki, A.M., A.Z. El-Yaski, and E. Youseif, Identifying neuropathic pain among patients with chronic low-back pain: use of the Leeds
Assessment of Neuropathic Symptoms and Signs pain scale. Regional Anesthesia & Pain Medicine, 2005. 30(5): p. 1-422.
23. Zilliox, L.A., et al., Clinical neuropathy scales in neuropathy associated with impaired glucose tolerance. Journal of diabetes and its
complications, 2015. 29(3): p. 372-377.
24. Avci, A.Y. and S. Avci, Peripheral Nerve Function Changes Due to Hypoxia in ObstructiveSleep Apnea. 2019.
25. Lüdemann, P., et al., Axonal polyneuropathy in obstructive sleep apnoea. Journal of Neurology, Neurosurgery & Psychiatry, 2001. 70(5): p. 685-687.
26. Mayer, P., et al., Peripheral neuropathy in sleep apnea: a tissue marker of the severity of nocturnal desaturation. American Journal of Respiratory and Critical Care Medicine, 1999. 159(1): p. 213-219.
27. Mihalj, M., L. Lušić, and Z. Đogaš, Reduced evoked motor and sensory potential amplitudes in obstructive sleep apnea patients. Journal of SleepResearch, 2016. 25(3): p. 287-295.
28. Tapan, Ö.O., U. Tapan, and Ü.S. Kılıç, Obstrüktif Uyku Apne Sendromlu Hastalarda Hipoksinin Göz Üzerine Etkileri. Journal of Turkish Sleep
Medicine, 2016. 2: p. 43-47.
29. Vila, A., et al., Neuropathies and chronic respiratory insufficiency: electrophysiologic study.Revue D'electroencephalographie et de
Neurophysiologie Clinique, 1986. 15(4): p. 331-340.
30. Dziewas, R., et al., Treatment for obstructive sleep apnoea: effect on peripheral nerve function.Journal of Neurology, Neurosurgery & Psychiatry, 2007. 78(3): p. 295-297.
31. EVLİCE, A., et al., Obstruktif Uyku Apne Sendromunda Nöropati ve Disotonomi Neuropathy and Dysautonomia in Patients with Obstructive
Sleep Apnea. 2015.
32. Sforza, E. and F. Roche, Chronic intermittent hypoxia and obstructive sleep apnea: an experimental and clinical approach. Hypoxia,
2016. 4: p. 99.
33. Song, D., et al., Chronic intermittent hypoxia exposure-induced atherosclerosis: a brief review.Immunologic research, 2015. 63(1): p. 121-130.
34. Deng, F., et al., Endothelial microvesicles in hypoxic hypoxia diseases. Journal of cellular and molecular medicine, 2018. 22(8): p. 3708-3718.
35. Kayacan, O., et al., Neurophysiological changes in COPD patients with chronic respiratory insufficiency. Acta neurologica belgica, 2001.
101(3): p. 160-165.
36. Frolkis, V.V., S.A. Tanin, and Y.N. Gorban, Agerelated changes in axonal transport. Experimental gerontology, 1997. 32(4-5): p. 441-450.
37. Malik, R., et al., Hypoxic neuropathy: relevance to human diabetic neuropathy. Diabetologia, 1990. 33(5): p. 311-318.
38. Wang, Y., et al., Ischemia–reperfusion injury of peripheral nerve in experimental diabetic neuropathy. Journal of the neurological sciences,
2004. 227(1): p. 101-107.
39. Bondy, S.C. and C.P. LeBel, The relationshipbetween excitotoxicity and oxidative stress in the central nervous system. Free Radical Biology and Medicine, 1993. 14(6): p. 633-642.
40. Hampton, K., et al., Resistance to ischaemic conduction failure in chronic hypoxaemia and diabetes. Journal of Neurology, Neurosurgery &
Psychiatry, 1989. 52(11): p. 1303-1305.
41. Faisal, H. T. ., Abid, M. K. ., & Abed, A. . (2022). Study Of Some Biochemical Parameters in Dose During Pregnancy in Goats. Journal Of Advanced Zoology, 43(1), 01–06. https://doi.org/10.17762/jaz.v43i1.109
42. Gulati, H. ., & Rana, S. . (2022). Habitat Preference and Current Threats to The Sarus Cranes Grus Antigone (Aves: Gruiformes:
Gruidae) In Important Bird Areas of Haryana, India: Implications for Determining EffectiveConservation Actions. Journal Of Advanced Zoology, 43(1), 07–16. Retrieved from http://jazindia.com/index.php/jaz/article/view/110
43. Mokhtar, A. R. R. A. S. . (2022). Development Of Saponin Based Wettable Powder Formulation from Phaleria macrocarpa To Control Pomacea maculate. Journal Of Advanced Zoology, 43(1), 17–31. Retrieved from http://jazindia.com/index.php/jaz/article/view/111.
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Mar 26, 2023
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How to Cite
Eman M Moazen, Shaimaa A. Maklad, Rabab Yahya Abd El-kareem, Hoda A Eid, marwa mohy eldin abdelrahman ahmed, Heba Shoman, Sami A Mohamed, Sara A Tahoun, Doaa Aly Abd El-fattah, Enas A Farrag, Ola I Saleh, Alshimaa Ezzat A. Enayet, Amany Ibrahim Abosaif, Amal H Ibrahim, & Ragy M Ghaly. (2023). Clinical and pathological assessment of Peripheral neuropathy in pulmonary sarcoidosis. Journal of Population Therapeutics and Clinical Pharmacology, 30(4), 53-67. https://doi.org/10.47750/jptcp.2023.30.04.007
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How to Cite
Eman M Moazen, Shaimaa A. Maklad, Rabab Yahya Abd El-kareem, Hoda A Eid, marwa mohy eldin abdelrahman ahmed, Heba Shoman, Sami A Mohamed, Sara A Tahoun, Doaa Aly Abd El-fattah, Enas A Farrag, Ola I Saleh, Alshimaa Ezzat A. Enayet, Amany Ibrahim Abosaif, Amal H Ibrahim, & Ragy M Ghaly. (2023). Clinical and pathological assessment of Peripheral neuropathy in pulmonary sarcoidosis. Journal of Population Therapeutics and Clinical Pharmacology, 30(4), 53-67. https://doi.org/10.47750/jptcp.2023.30.04.007