Inflammatory and immune mediated sensory neuropathies
Human sensory neuropathies having an inflammatory component or presumed immune pathogenesis are reviewed. Sensory forms of acute (Miller Fisher syndrome) and chronic idiopathic demyelinating polyradiculoneuropathy are probably due to autoimmune responses against antigens relatively restricted to the myelin of sensory nerves. Subacute sensory neuronopathy associated with small cell carcinoma of the lung is caused by dorsal root ganglionitis: an antibody against a neuronal nuclear antigen is characteristically present in this syndrome and may be important in pathogenesis. Similar mechanisms might explain the dorsal root ganglionitis associated with Sjögren’s syndrome and the inflammation of the trigeminal ganglion which is thought to underlie benign trigeminal neuropathy. Nonspecific inflammatory disorders, including amyloid deposition, granulomas associated with leprosy or sarcoidosis, and vasculitis, also produce sensory neuropathy. The leakiness of the blood-nerve barrier and the presence of satellite cells expressing MHC class II antigen in the dorsal root ganglion may contribute to the susceptibility of sensory nerves to autoimmune damage.
KeywordsDorsal Root Ganglion Sensory Neuropathy Mixed Connective Tissue Disease Lepromatous Leprosy Miller Fisher Syndrome
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