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J Neurol Sci. 2014 Oct 15;345(1-2):184-8. doi: 10.1016/j.jns.2014.07.040. Epub 2014 Jul 26.

Vitamin D deficiency in patients with primary immune-mediated peripheral neuropathies.

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Institute of Neuroscience, Department of Clinical Neurophysiology, Uppsala University, Uppsala, Sweden.
Institute of Neuroscience, Department of Neurology, Uppsala University, Uppsala, Sweden.
Institute of Neuroscience, Department of Clinical Neurophysiology, Uppsala University, Uppsala, Sweden. Electronic address:



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.


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.


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).


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.


Autoimmune; CIDP; Chronic inflammatory demyelinating polyneuropathy; GBS; Guillain–Barre syndrome; Vitamin D

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