Faculty Collaboration Database

Direct immunofluoresence in vasculitic neuropathy: specificity of vascular immune deposits. Muscle Nerve 2010 Jul;42(1):62-9

Date

06/15/2010

Pubmed ID

20544917

DOI

10.1002/mus.21639

Scopus ID

2-s2.0-77954134117 (requires institutional sign-in at Scopus site)   24 Citations

Abstract

In suspected vasculitic neuropathy, vasculitis is demonstrated in only 30% of superficial peroneal nerve (SPN)/peroneus brevis muscle (PBM) specimens. Pathologic predictors of vasculitis are thus needed for non-diagnostic cases. Immune deposits in epineurial vessels have an established sensitivity but unknown specificity. In this study we assessed specificity using direct immunofluorescence (DIF) in SPN/PBM biopsies for suspected vasculitic neuropathy. Biopsies from 13 patients with vasculitis, 13 without vasculitis, and 6 with diabetic radiculoplexus neuropathy (DRPN) were stained for immunoglobulin G (IgG), IgM, and complement 3 (C3), and analyzed in a blinded manner. Vascular immunoglobulin or C3 deposits occurred in 12 of 13 nerve or muscle biopsies (11 of 13 nerves, 5 of 13 muscles) in vasculitis vs. 1 of 13 (1 of 13 nerves, 0 of 13 muscles) in controls (P = 0.00003). Specificity was 92%. For DRPN, vascular immune deposits occurred in 5 of 6 nerves or muscles (4 of 6 nerves, 1 of 5 muscles), similar to vasculitis but significantly different from controls. Epineurial/perimysial vascular deposits of immunoglobulin/C3 by DIF are a specific marker of vasculitic neuropathy.

Author List

Collins MP, Periquet-Collins I, Sahenk Z, Kissel JT

Author

Michael P. Collins MD Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Biopsy
Cohort Studies
Complement C3
Diabetic Neuropathies
Female
Fluorescent Antibody Technique, Direct
Humans
Immunoglobulin G
Immunoglobulin M
Male
Middle Aged
Muscle, Skeletal
Peripheral Nervous System Diseases
Peroneal Nerve
Regional Blood Flow
Vasculitis