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Any ideas for a Diagnosis?

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Old 04-03-2012, 01:43 PM   #1
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Any ideas for a Diagnosis?

I just left the Surgeon who did the sural nerve biopsy, he read the results to me today & then said I have small fibre neuropathy. A week before, the Neurologist Dr. read the report to me & said I do not have SFN. I am quoting the pathologist report. If anyone can help me , as these 2 Dr.s do not know to much, I would be greatfull. Microscopic Examination: Microscopic examination of paraffin embedded material reveals a single vessel surrounded by a very scanty mononuclear inflammatory infiltration, positive with leukocyte common antigen antibody. One of several fascicles in the specimen shows focal loss of myelinated axons. There is also diffuse endoneurial fibrosis in another fascicle. There is no sign of amyloid deposition. Multiple deeper sections show no additional vessels surrounded by inflammatory infiltration. Plastic embedded tissue shows poor preservation of the specimen. However, one out of three blocks shows several vessels surrounded by scanty mononuclear inflammatory infiltration. Diagnosis: changes suggestive of low grade small vessel vasculitis with focal loss axons.

Sorry for the length of this post. Thanks for reading. June

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Old 04-04-2012, 09:41 AM   #2
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Re: Any ideas for a Diagnosis?

I would have to go with the surgeon on this one. What you have is two doctors that read a pathological report and saw two different things. I would speak to your neurologist about what the surgeon said and ask if the two could confer on your diagnosis. Either way you may need a new neurologist.

Axon damage is common in MS and SFN.

Good luck, this is a tough position to be in.

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