Highlights
- •All patients with autoimmune peripheral neuropathies (PNP) had vitamin D deficiency.
- •Vitamin D levels were lower in patients with PNP than in healthy controls.
- •Motor neuron disease patients had comparable vitamin D status to healthy controls.
- •We suggest monitoring of vitamin D status in PNP patients.
Abstract
Purpose
T cells are important in the immunopathology of immune-mediated peripheral neuropathies
(PNP) and activated vitamin D regulates the immune response through increasing the
amount of regulatory T cells. An association between vitamin D deficiency and polyneuropathy
has been stipulated; hence we assessed whether patients with primary immune-mediated
PNP have low vitamin D [25(OH)D] levels.
Methods
Plasma levels of 25(OH)D were analyzed in 26 patients with primary immune-mediated
PNP, 50 healthy matched blood donors and 24 patients with motor neuron disease (MND).
INCAT score was assessed in patients with Guillain–Barré syndrome and chronic inflammatory
demyelinating polyneuropathy. ALSFRS-R score was applied to MND patients and the modified
Rankin (mRankin) scale compared disability among patient groups.
Results
Mean 25(OH)D value in PNP patients was 40 ± 16 nmol/l, compared to 69 ± 21 nmol/l in healthy blood donors (p < 0.001). MND patients had a higher mean 25(OH)D than PNP patients (59 ± 26 nmol/L; p = 0.006) and comparable levels to healthy blood donors (p = 0.15). Mean 25(OH)D value was not higher in PNP patients with pre-existing vitamin
D3 supplementation of 800 IU/day (N = 6; 35 ± 18 nmol/L) than in unsupplemented PNP patients (42 ± 16 nmol). INCAT score ranged from 0 to 10 (mean 3.5) and ALSFRS-R ranged from 11 to 44
(mean 31). mRankin score was more severe in MND patients (mean 3.5) compared to PNP
patients (mean 2.1).
Conclusions
All patients with primary immune-mediated PNP were diagnosed with vitamin D deficiency
and they had significantly lower 25(OH)D values than healthy control persons and MND
patients. We suggest monitoring of vitamin D status in patients with autoimmune PNP,
since immune cells are responsive to the ameliorative effects of vitamin D.
Keywords
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Article info
Publication history
Published online: July 26, 2014
Accepted:
July 17,
2014
Received in revised form:
July 15,
2014
Received:
March 4,
2014
Identification
Copyright
© 2014 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
