Sural Nerve Biopsy Diagnosis

Diagnostic value of sural nerve biopsy in chronic inflammatory demyelinating polyneuropathy

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Table 1 Diagnoses other than CIDP in 41 patients

Table 1

Diagnoses other than CIDP in 41 patients

Diagnosis	Patients (n)
Vasculitis neuropathy	6
Neuropathy with monoclonal gammopathy	5
Multiple sclerosis and neuropathy	3
Inherited neuropathy	2
Neuropathy with non-Hodgkin’s lymphoma	1
Myotonic dystrophy with neuropathy	1
Lyme neuropathy	1
Alcohol neuropathy	2
Guillain-Barré syndrome	1
Neuropathy of unknown aetiology:
Chronic axonal polyneuropathy18	7
Not classified	11
No neuropathy	1

In the group of patients with a diagnosis other than CIDP, biopsy results of nine patients were consistent with CIDP. Twoof these patients had multiple sclerosis and neuropathy. Thesepatients had no symmetric sensorimotor neuropathy of the armsand legs, no areflexia, and physiological studies were not consistentwith demyelination. Their biopsies showed demyelination.

OBJECTIVE DIAGNOSTIC VALUE OF SIX CLINICAL FEATURES AND SURAL NERVE BIOPSY
Table2 shows the sensitivity, specificity, and positive LR for CIDP of the six clinical features and sural nerve biopsy.

Table 2 Clinical features and sural nerve biopsy in 23 patients with CIDP
Clinical feature Sensitivity Specificity Positive LR for CIDP
(1) Remitting course 0.39 0.88 3.21
(2) sensorimotor neuropathy 0.70 0.78 3.17
(3) Areflexia 0.52 0.80 2.67
(4) Raised CSF protein concentration (>0.5 g/l) 0.87 0.44 1.55
(5) Neurophysiological studies consistent with CIDP 0.87 0.85 5.94
(6) Absence of comorbidity 0.65 0.63 1.78
(7) Sural nerve biopsy consistent with CIDP 0.61 0.78 2.77

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Diagnostic value of sural nerve biopsy in chronic inflammatory demyelinating polyneuropathy

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