Polyoliosa

Polyoliosa is a term used in medical literature to describe a proposed spectrum of disorders involving dysregulation of the polyol pathway, the metabolic route that bridges glucose to sugar alcohols such as sorbitol. The term is not standardized and its usage is limited to a small number of theoretical discussions and case reports. It aims to capture conditions with abnormal accumulation of polyols in tissues.

Pathophysiology centers on the polyol pathway. Under normal conditions, aldose reductase reduces glucose to sorbitol, which sorbitol dehydrogenase converts to fructose. In Polyoliosa this balance is disturbed, leading to sorbitol accumulation, osmotic stress, and oxidative injury. Tissues with limited sorbitol dehydrogenase activity, such as the lens, nerves, kidneys, and retina, are particularly affected.

Clinical features are multisystemic and variable. Reported manifestations include progressive peripheral neuropathy, cataracts, nephropathy, and autonomic symptoms. The syndrome is often associated with diabetes or metabolic syndrome but can occur in non-diabetic individuals as part of broader metabolic dysregulation.

Diagnosis is not standardized. It is typically made by exclusion and supported by laboratory profiling of polyol levels in plasma or cells, along with assays of oxidative stress and aldose reductase activity. Imaging and functional testing document organ involvement.

Management emphasizes control of underlying metabolic risk factors; no disease-specific therapy is established. Experimental approaches have included aldose reductase inhibitors and antioxidants, but evidence remains limited. Prognosis depends on the extent of organ involvement and the success of risk-factor management.

Polyoliosa remains a niche term and is not included in major diagnostic classifications such as ICD-10/11. Current guidance is limited to selected reports, underscoring the need for standardized criteria and further research.