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- Title
Small Fiber Neuropathy Associated with Post-COVID-19 and Post-COVID-19 Vaccination Arthritis: A Rare Post-Infective Syndrome or a New-Onset Disease?
- Authors
Bandinelli, Francesca; Nassini, Romina; Gherardi, Eleonora; Chiocchetti, Barbara; Manetti, Mirko; Cincotta, Massimo; Nozzoli, Filippo; Nucci, Elena; De Logu, Francesco; Pimpinelli, Nicola
- Abstract
Post-COVID-19 (PC) and post-COVID-19 vaccination (PCV) syndromes are considered emergent multidisciplinary disorders. PC/PCV small fiber neuropathy (SFN) was rarely described and its association with undifferentiated arthritis (UA) was never defined. We aimed to evaluate PC/PCV-UA associated with the recent onset of severe lower limb paresthesia, compare SFN positive (+) to negative (−) patients, and evaluate changes in biomarkers in SFN+ during treatments. Nineteen PC/PCV-UA-patients with possible SFN underwent skin biopsy at the Usl Tuscany Center (Florence) early arthritis outpatient clinic from September 2021 to March 2024. Eight selected SFN+ were compared to ten SFN− patients. In SFN+ patients, baseline joint ultrasound (US), electromyography (EMG), optical coherence tomography (OCT), and skin biopsy were repeated at six months. Moreover, SFN+ patients were clinically assessed by a 0–10 numeric rating scale for neurological symptoms and DAS28/ESR up to 12 months follow-up. SFN+ patients showed a lower intraepidermal nerve fiber density at histopathological examination of skin biopsies and a higher frequency of OCT and EMG abnormalities in comparison to SFN− patients. In SFN+ patients, US and DAS28/ESR significantly improved, while intraepidermal nerve fiber density did not significantly change at the six-month follow-up. Fatigue, motor impairment, burning pain, brain fog, and sensitivity disorders decreased at long-term follow-up (12 months).
- Subjects
OPTICAL coherence tomography; SKIN biopsy; NERVE fibers; COVID-19 pandemic; SKIN examination; POLYPOIDAL choroidal vasculopathy; PARESTHESIA
- Publication
Journal of Personalized Medicine, 2024, Vol 14, Issue 8, p789
- ISSN
2075-4426
- Publication type
Article
- DOI
10.3390/jpm14080789