Therapath Neuropathology

New study examines fixative solutions used in skin biopsy test for small fiber neuropathy

January 21, 2016

Cautions that one method may provide incorrect diagnosis

NEW YORK, January 20, 2016 /PRNewsire/ — Therapath LLC, a leader in neuropathology, finalized a comparison study of the most common fixation methods used in Epidermal Nerve Fiber Density (ENFD) testing for the determination of small fiber neuropathy. The study concluded that proper fixation technique is critical for test accuracy.

The study, published in Clinical Neuropathology, compared the results of immune staining on tissue shipped in PLP (2% paraformaldehyde lysine periodate) fixative and Zamboni’s (2% paraformaldehyde, picric acid) solution. The study also looked into the effects of ambient shipping on biopsy specimens shipped in Zamboni’s solution.

The published study can be found in Clinical Neuropathology Volume 35, No. 1/2016 (January/February)

The study reached two significant conclusions:

  1. PLP and Zamboni’s fixatives can be used interchangeably for fixation of punch skin biopsies and determination of the ENFD when the samples are kept cool during transit.
  2. Specimens shipped in Zamboni’s solution at ambient temperature presented with a significant reduction of immune staining that could lead to an incorrect diagnosis of small fiber neuropathy.

Therapath currently offers ENFD testing to hospitals, private practices, reference laboratories, and research organizations. Therapath offers a choice of PLP or Zamboni’s fixative and always provides protective shipping coolers and cold packs for transportation.  Services are offered worldwide.

About Therapath Neuropathology:
Therapath Neuropathology is a privately held specialized laboratory with six board certified neuropathologists. The company is licensed through CLIA and accredited by the College of American Pathology (CAP).

In addition to testing for small fiber neuropathy, Therapath offers brain and spinal cord autopsy pathology, muscle and nerve biopsy pathology, and ophthalmic pathology.


Contact Information:
Geoffrey Whitehouse
Therapath Neuropathology