The Role of Sural Nerve Biopsy in the Diagnosis of Vasculitis
Gisslander, Karl LU
; Dahlin, Lars B.
LU
; Smith, Rona
; Jayne, David
; O’Donovan, Dominic G.
and Mohammad, Aladdin J.
LU
(2022)
In Journal of Rheumatology
49(9).
p.1031-1036
- Abstract
Objective. The diagnostic yield of sural nerve biopsy (SNB) in vasculitis is uncertain. Our aim was to document relevant characteristics of patients undergoing SNB in the investigation of vasculitis; determine the diagnostic yield; relate positive biopsy findings to patient demographic, laboratory, and clinical variables; and to calculate the rate of surgical complications. Methods. Patients with suspected vasculitis that underwent SNB as part of diagnostic evaluation at academic medical centers in Sweden and the United Kingdom were identified by searching local pathology databases and clinic registers. A structured review of medical case records and pathology reports was conducted. Histological findings were categorized as definite,... (More)
Objective. The diagnostic yield of sural nerve biopsy (SNB) in vasculitis is uncertain. Our aim was to document relevant characteristics of patients undergoing SNB in the investigation of vasculitis; determine the diagnostic yield; relate positive biopsy findings to patient demographic, laboratory, and clinical variables; and to calculate the rate of surgical complications. Methods. Patients with suspected vasculitis that underwent SNB as part of diagnostic evaluation at academic medical centers in Sweden and the United Kingdom were identified by searching local pathology databases and clinic registers. A structured review of medical case records and pathology reports was conducted. Histological findings were categorized as definite, probable, or no vasculitis in accordance with the 2015 Brighton Collaboration reinterpretation and update of the Peripheral Nerve Society guidelines for vasculitic neuropathy. Definite and probable findings were considered positive for vasculitis. Results. Ninety-one patients that underwent SNB were identified (45% female). Forty (44%) patients showed histological evidence of vasculitis: 14 definite and 26 probable. A concomitant muscle biopsy conducted in 10 patients did not contribute to the diagnostic yield. Positive antineutrophil cytoplasmic antibody test, organ involvement other than the nervous system, and a longer biopsy sample were associated with a positive biopsy. The reported surgical complication rate was 15%. Conclusion. SNB of sufficient length is a useful procedure to confirm a diagnosis of vasculitis.
(Less)
- author
- Gisslander, Karl
LU
; Dahlin, Lars B.
LU
; Smith, Rona
; Jayne, David
; O’Donovan, Dominic G.
and Mohammad, Aladdin J.
LU
- organization
- publishing date
- 2022-09-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- antineutrophil cytoplasmic antibodies, biopsy, neurologic manifestations, vasculitis
- in
- Journal of Rheumatology
- volume
- 49
- issue
- 9
- pages
- 6 pages
- publisher
- Journal of Rheumatology Publishing Company Limited
- external identifiers
-
- scopus:85140417070
- pmid:35649553
- ISSN
- 0315-162X
- DOI
- 10.3899/jrheum.211406
- language
- English
- LU publication?
- yes
- id
- f958fbf7-55a4-4cb4-b3d3-831ae5b405b6
- date added to LUP
- 2022-12-16 11:43:45
- date last changed
- 2024-12-13 00:17:24
@article{f958fbf7-55a4-4cb4-b3d3-831ae5b405b6,
abstract = {{<p>Objective. The diagnostic yield of sural nerve biopsy (SNB) in vasculitis is uncertain. Our aim was to document relevant characteristics of patients undergoing SNB in the investigation of vasculitis; determine the diagnostic yield; relate positive biopsy findings to patient demographic, laboratory, and clinical variables; and to calculate the rate of surgical complications. Methods. Patients with suspected vasculitis that underwent SNB as part of diagnostic evaluation at academic medical centers in Sweden and the United Kingdom were identified by searching local pathology databases and clinic registers. A structured review of medical case records and pathology reports was conducted. Histological findings were categorized as definite, probable, or no vasculitis in accordance with the 2015 Brighton Collaboration reinterpretation and update of the Peripheral Nerve Society guidelines for vasculitic neuropathy. Definite and probable findings were considered positive for vasculitis. Results. Ninety-one patients that underwent SNB were identified (45% female). Forty (44%) patients showed histological evidence of vasculitis: 14 definite and 26 probable. A concomitant muscle biopsy conducted in 10 patients did not contribute to the diagnostic yield. Positive antineutrophil cytoplasmic antibody test, organ involvement other than the nervous system, and a longer biopsy sample were associated with a positive biopsy. The reported surgical complication rate was 15%. Conclusion. SNB of sufficient length is a useful procedure to confirm a diagnosis of vasculitis.</p>}},
author = {{Gisslander, Karl and Dahlin, Lars B. and Smith, Rona and Jayne, David and O’Donovan, Dominic G. and Mohammad, Aladdin J.}},
issn = {{0315-162X}},
keywords = {{antineutrophil cytoplasmic antibodies; biopsy; neurologic manifestations; vasculitis}},
language = {{eng}},
month = {{09}},
number = {{9}},
pages = {{1031--1036}},
publisher = {{Journal of Rheumatology Publishing Company Limited}},
series = {{Journal of Rheumatology}},
title = {{The Role of Sural Nerve Biopsy in the Diagnosis of Vasculitis}},
url = {{http://dx.doi.org/10.3899/jrheum.211406}},
doi = {{10.3899/jrheum.211406}},
volume = {{49}},
year = {{2022}},
}