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Abnormal Osmolality Gap Exists in Distal Symmetric Polyneuropathy
Tetsuya Akaishi1,2, Toshiyuki Takahashi1,3, Ichiro Nakashima4
1Department of Neurology, Tohoku University Graduate School of Medicine.
The Tohoku Journal of Experimental Medicine
|October 2, 2018
Summary
Osmotic factors may play a role in distal symmetric polyneuropathy. This study found abnormal serum osmolality gap values in patients with acute distal polyneuropathy, suggesting osmotic imbalance as a potential cause.
Area of Science:
- Neurology
- Biochemistry
- Pathophysiology
Background:
- Distal symmetric polyneuropathy (DSP) is a common neurological condition with largely unknown pathogenesis.
- Genetic mutations and auto-antibodies are known causes in some DSP cases.
- Osmotic factors are implicated in other neurological disorders, prompting investigation into their role in DSP.
Purpose of the Study:
- To investigate the potential association of osmotic factors in the pathogenesis of distal polyneuropathy.
- To assess serum osmolality and related parameters in patients with acute DSP compared to other neurological conditions.
Main Methods:
- Prospective measurement of serum osmolality, electrolytes, total protein, albumin, BUN, glucose, and osmolality gap.
- Study included 12 patients with acute DSP and 176 patients with other neurological disorders (e.g., MS, neurodegenerative diseases).
- Comparison of osmotic parameters between the DSP group and the control group.
Main Results:
- All 12 patients with acute DSP exhibited abnormal serum osmolality gap values (p < 0.0001).
- Abnormal osmolality gap values in the control group were attributed to hyperlipidemia or unrelated auto-antibodies.
- No significant osmotic abnormalities were found in the control group unrelated to specific conditions.
Conclusions:
- Serum osmolality gap is frequently altered in the acute phase of distal symmetric polyneuropathy.
- Osmotic imbalance between serum and nerve cells, possibly due to unidentified osmolytes, may contribute to DSP.
- This finding suggests a novel potential mechanism for DSP of unknown etiology.
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