Sarcoidosis (SC) is the granulomatous disease of an unknown origin, where the differential diagnosis with Tuberculosis (TB) is challenging and vital for patients’ prognosis. The common neurological complication in SC is a Small Fiber Neuropathy (SFN) that is considered to be the result of the chronic inflammation, and remains significantly understudied. Aim: To identify the clinical and histological correlates of the small fiber neuropathy in sarcoidosis and tuberculosis patients.
The study was performed in 2018-2019 years and included 71 patients with pulmonary sarcoidosis (n=25), pulmonary tuberculosis (n=21), and healthy subjects (n=25). For the clinical verification of the SFN, the “Small fiber neuropathy screening list” (SFN-SL) was used. A punch biopsy of the skin was performed followed by the enzyme immunoassay analysis with PGP 9.5 antibodies. Up to 60% of sarcoidosis patients and 19% tuberculosis patients report the presence of at least one complaint, which may be associated with SFN. The most frequent complaints included dysfunctions of the cardiovascular, musculoskeletal system and gastrointestinal tract. A negative, statistically significant correlation between the Intra-epidermal Nerve Fiber Density (IEND) and SFN-SL score was revealed in both groups.
