Epidermal Nerve Fiber Density Consultation, Varies
Use
This test is useful for investigating polyneuropathies, particularly when there's a need to assess small fiber involvement that traditional methods fail to detect. The advent of epidermal skin biopsies and the use of PGP 9.5 immunohistochemistry now allows for the direct visualization and assessment of small sensory fibers within the skin. This method has been validated with acceptable sensitivity and specificity, offering a minimally invasive option for reliably identifying pathological changes in small fiber neuropathy across various conditions like diabetes, HIV, lupus, and neurosarcoidosis. It provides a quantitative measure of intraepidermal nerve fiber density, facilitating the diagnosis and characterization of polyneuropathies.
Special Instructions
All requisition forms and supporting information need to be in English. Ensure that patient information like name, date of birth, medical record number, and contact details of the referring pathologist or provider are included. Utilize the Epidermal Nerve Fiber Density Kit for sample collection; no substitutions are accepted. The samples should be transported following the specific preparation instructions available in the provided guidelines.
Limitations
The neuropathologist's interpretation can be hindered by poor fixation, orientation, and handling of the tissue prior to testing. The visualization of epidermal nerve fibers cannot be performed on paraffin blocks, and PGP 9.5 staining reactions are not suitable for previously embedded tissue. Re-testing at an additional charge might be necessary if improper specimen preparation or submission occurs. Additional tests that are deemed unnecessary by the reviewing pathologist may not be performed.
New York Approved
Methodology
Immunoassay (IHC)
Biomarkers
LOINC Codes
- In Process
- 59465-5
- 19139-5
- 35265-8
- 22634-0
- 81178-6
- 80398-1
- 62364-5
Result Turnaround Time
7-14 days
Related Documents
For more information, please review the documents below
Specimen
Tissue
Volume
Not provided
Minimum Volume
Not provided
Container
Epidermal Nerve Fiber Density Kit
Collection Instructions
Collect two 3-mm skin punch biopsies from the same side of the body. Follow the specimen preparation instructions detailed in the Epidermal Nerve Fiber Density Preparation Instructions.
Storage Instructions
Transport the specimen refrigerated as preferred. Ambient temperature is also acceptable.