When is a biopsy indicated in the workup of diabetic lumbosacral plexopathy?

Updated: Jan 04, 2021
  • Author: Divakara Kedlaya, MBBS; Chief Editor: Milton J Klein, DO, MBA  more...
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Answer

Biopsies are rarely indicated in patients with diabetic lumbosacral plexopathy, and systematic studies are lacking in the literature. Early in the disease course, epineurial and perivascular inflammation around the small vessels may be caused by infiltration by mononuclear cells, with or without polymorphonuclear cells. Endoneurium and subperineurial space immunoglobulin-M (IgM) deposition should be expected. Activated complement (C5b-9) deposition in the endothelium of small vessels is also common. Reduced numbers of myelinated and unmyelinated axons may be observed, and differential fascicular loss of axons is also characteristic.


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