The Importance of Estrogen Receptors in Aetiopathogenesis of Carpal Tunnel Syndrome in Postmenopausal Women

Abstract

Introduction: Carpal Tunnel Syndrome (CTS) is a common peripheral neuropathy in postmenopausal women which is caused by compression of the median nerve in the carpal tunnel. Although mostly idiopathic, the aetiopathogenesis of CTS was not quite clear. Aim: To verify the possible role of the estrogen surges and the presence of Estrogen Receptor (ER) in tenosynovial tissue on postmenopausal period, in the pathogenesis of idiopathic CTS. Materials and Methods: This retrospective study was conducted on 16 patients with CTS in premenopausal group (group 1) and 18 patients with CTS in postmenopausal group (group 2). In this study, tenosynovial tissue samples of patients who had surgery due to CTS were used. Biopsy samples of 34 patients who were operated in the Neurosurgery Department of KSBU Medical Faculty Evliya Celebi Training and Research Hospital between January 2011 and January 2012 were included in the study. An examination was made by Haematoxylin and Eosin (H&E) in the tenosynovial tissue. ER was performed by immunohistochemistry on tissue samples. The non inflammatory fibrosis, vascular proliferation and oedema were observed. A nuclear staining for ER was observed in synovial lining cells and fibroblasts in the tenosynovial tissue. Results: The number of positive cells for ER in the tenosynovial tissue in postmenopausal patients with CTS was found higher according to premenopausal patients with CTS (p-value<0.01). A high association was found among patient age, severe EMG findings and ER positivity. Conclusion: ER surges in postmenopausal period and increased ER positivity in the tenosynovial tissue in the aetiopathogenesis of CTS.

Keywords

• compression neuropathy
• histomorphology
• hormone receptor
• immunohistochemistry
• menopausal period