How is HIV-associated distal painful sensorimotor polyneuropathy diagnosed?

Updated: Aug 08, 2019
  • Author: Florian P Thomas, MD, PhD, MA, MS; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Answer

Consider the following in the workup:

  • HIV RNA viral load

  • Complete blood cell count

  • Fasting blood sugar and 2-hour glucose tolerance test

  • Hemoglobin A1C

  • Antinuclear antibody screen

  • Extractable nuclear antibody screen

  • Erythrocyte sedimentation rate

  • Renal function test

  • Paraproteinemia workup

  • Angiotensin-converting enzyme level

  • Lyme serology

  • Thyroid function tests

  • Hepatitis workup

  • Vitamin B-12 and folic acid levels

In patients with B-12 levels below 350 pg/mL, homocysteine and methylmalonic acid levels are more sensitive indicators of a deficiency. Intrinsic factor or parietal cell antibody testing may be indicated.

Cerebrospinal fluid analysis may show mildly elevated protein or mild pleocytosis.


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