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Screening laboratory studies in a distal, symmetric polyneuropathy may include a complete blood count, basic chemistries including serum electrolytes and tests of renal and hepatic function, fasting blood glucose, HbA1c, urinalysis, thyroid function tests, B12, folate, ESR, rheumatoid factor, antinuclear antibodies (ANA), serum protein electrophoresis (SPEP) and immunoelectrophoresis or immunofixation, and urine for Bence Jones protein. An oral glucose tolerance test is indicated in pts with painful sensory neuropathies even if other screens for diabetes are negative.
Tests to further characterize the neuropathy include nerve conduction studies (NCS), electromyography (EMG), sural nerve biopsy, muscle biopsy, skin biopsies, and quantitative sensory testing. Diagnostic tests are more likely to be informative in pts with asymmetric, motor-predominant, rapid-onset, or demyelinating neuropathies.
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Loscalzo, Joseph, et al., editors. "POLYNEUROPATHY." Harrison's Manual of Medicine, 19th ed., McGraw Hill Inc., 2017. harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623485/all/POLYNEUROPATHY.
POLYNEUROPATHY. In: Loscalzo J, Jameson JL, Longo DL, et al, eds. Harrison's Manual of Medicine. 19th ed. McGraw Hill Inc.; 2017. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623485/all/POLYNEUROPATHY. Accessed October 15, 2019.
POLYNEUROPATHY. (2017). In Loscalzo, J., Jameson, J. L., Longo, D. L., Hauser, S. L., Fauci, A. S., & Kasper, D. L. (Eds.), Harrison's Manual of Medicine. Available from https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623485/all/POLYNEUROPATHY
POLYNEUROPATHY [Internet]. In: Loscalzo J, Jameson JL, Longo DL, Hauser SL, Fauci AS, Kasper DL, editors. Harrison's Manual of Medicine. McGraw Hill Inc.; 2017. [cited 2019 October 15]. Available from: https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623485/all/POLYNEUROPATHY.
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