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Autoimmune and Infectious Neuropathies

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Abstract

Small nerve fibers, either sensory or autonomic, are commonly involved in various immune-mediated and infectious disorders. More than 60% of patients with Sjögren’s disease or systemic lupus erythematosus and a third of patients with sarcoidosis have evidence of small fiber neuropathy on history, examination, or skin biopsy. Patients with antibody-mediated disorders, such as voltage-gated potassium channels, commonly complain of symptoms suggestive of small fiber neuropathy. On physical examination, the presence of non-length-dependent pattern of sensory loss suggests an immune-mediated disorder, while patchy nerve fiber involvement suggests a vasculitic etiology. Infectious disorders such as leprosy, hepatitis C virus, and HIV virus remain common causes of small fiber neuropathy. Therapeutic interventions will focus on treatment of the underlying disease with symptomatic management of the pain and autonomic symptoms.

Keywords

  • Sjögren’s syndrome
  • Systemic lupus erythematosus
  • Voltage-gated potassium channel
  • Contactin-associated protein-like 2 (CASPR2)
  • Rheumatoid arthritis
  • Cardiac autonomic neuropathy
  • Sarcoidosis
  • Celiac disease
  • Human immunodeficiency virus
  • Hepatitis C
  • Cryoglobulinemia
  • Varicella zoster virus
  • Leprosy
  • Lyme disease

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  • DOI: 10.1007/978-981-13-3546-4_10
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Correspondence to Christopher H. Gibbons .

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Abuzinadah, A.R., Gibbons, C.H. (2019). Autoimmune and Infectious Neuropathies. In: Hsieh, ST., Anand, P., Gibbons, C., Sommer, C. (eds) Small Fiber Neuropathy and Related Syndromes: Pain and Neurodegeneration. Springer, Singapore. https://doi.org/10.1007/978-981-13-3546-4_10

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  • DOI: https://doi.org/10.1007/978-981-13-3546-4_10

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