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Somatic and autonomic small fiber neuropathy induced by bortezomib therapy: an immunofluorescence study.

Summary of "Somatic and autonomic small fiber neuropathy induced by bortezomib therapy: an immunofluorescence study."

Bortezomib is a new chemotherapeutic agent approved for the treatment of relapsed/refractory and newly diagnosed multiple myeloma. One of the major side effects of bortezomib is a peripheral length-dependent sensory axonal neuropathy and, less frequently, a small fiber neuropathy. Autonomic symptoms like postural dizziness, syncope, diarrhoea, ileus, impotence and urinary disturbances have been reported, nevertheless, autonomic neuropathy has never been characterized. We describe by means of immunofluorescence, the involvement of autonomic skin nerve fibers in three patients with small fiber neuropathy induced by bortezomib treatment.

Affiliation

Dipartimento di Scienze Neurologiche, Università di Bologna, Via Ugo, Foscolo 7, 40123, Bologna, Italy, mpgiannoccaro@gmail.com.

Journal Details

This article was published in the following journal.

Name: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiol
ISSN: 1590-3478
Pages:

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Medical and Biotech [MESH] Definitions

Disorder of the peripheral nerves that primarily impair small nerve fibers. The affected small nerve fibers include myelinated A-delta fibers (see A FIBERS) and unmyelinated C FIBERS. Because these small fibers innervate skin and help control autonomic function, their neuropathy presents with neuropathic pain, reduced thermal and pain sensitivity, and autonomic dysfunction (e.g. abnormal sweating or facial flushing). Small fiber neuropathy can be idiopathic or associated with underlying diseases (e.g., AMYLOIDOSIS; DIABETES MELLITUS; SARCOIDOSIS; or VASCULITIS).

Peripheral, autonomic, and cranial nerve disorders that are associated with DIABETES MELLITUS. These conditions usually result from diabetic microvascular injury involving small blood vessels that supply nerves (VASA NERVORUM). Relatively common conditions which may be associated with diabetic neuropathy include third nerve palsy (see OCULOMOTOR NERVE DISEASES); MONONEUROPATHY; mononeuropathy multiplex; diabetic amyotrophy; a painful POLYNEUROPATHY; autonomic neuropathy; and thoracoabdominal neuropathy. (From Adams et al., Principles of Neurology, 6th ed, p1325)

The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors.

A class of nerve fibers as defined by their structure, specifically the nerve sheath arrangement. The AXONS of the unmyelinated nerve fibers are small. The axons to SCHWANN CELLS ratio is greater in the unmyelinated nerve fibers than that in the myelinated fiber (NERVE FIBERS, MYELINATED) which is 1:1. Usually several axons are surrounded by a single Schwann cell in the unmyelinated nerve fibers. Therefore, each unmyelinated fiber is not completely covered by the MYELIN SHEATH formed by the Schwann cell. Unmyelinated nerve fibers conduct impulses at low velocities. They represent the majority of peripheral sensory and autonomic fibers. They are also found in the spinal cord and brain.

A TEXTILE fiber obtained from the pappus (outside the SEEDS) of cotton plant (GOSSYPIUM). Inhalation of cotton fiber dust over a prolonged period can result in BYSSINOSIS.

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