[villier]

Finally got some information from tests and skin biopsy can anyone translate into plain english please.


Sensory testing showed normal thermal thresholds from the arms and the soles for cool sensation, whereas warm sensation threshold were elevated particulary in the left sole.There was a suggestion of cool allodynia in the soles, and to a lesser extent in the palms. If anything heat pain thresholds were also decreased, suggesting hypersensitivity to noxious stimuli.

In keeping with the above, skin biopsy from the right calf showed normal values for the gold standard structural marker PGP 9.5 but with markedly elevated nerve fibres for the heat Capsaicin recepter TRPV1 and regenerating fibres with Gap43.The biopsy shows over expression of ion channels that are related to pain, and this is something we have seen in other patients with an inflammatory proximal affecting the dorsal root ganglia or the nerve roots.

We have also sometimes seen this pattern in patients with toxic or post-chemotherapy neuropathy i.e abnormal regenerating fibres, but there is no suggestion of such a condition here. I note that autoimmune tests were negative, and while her ANA was weakly positive at 1 in 40 this is considered clinically insignificant. The clinical features and biopsy also suggest that she does not have a channelopathy such as Nav1.7.

I would be very grateful if anyone can decipher this.............Marie