Improvement of small fiber neuropathy in a sarcoidosis patient after treatment with infliximab.
We describe a patient with severe small fiber neuropathy (SFN) accompanied by autonomic involvement, who was experimentally treated with infliximab, an anti-tumour necrosis factor-alpha (TNF-alpha) therapy. Six months after this treatment was started his symptoms completely resolved. Until now they did not return. Repeated temperature threshold testing (TTT) as well as cardiovascular autonomic function test clearly improved after one year therapy. This case reveals two important issues. First, it shows that SFN seems not an irreversible disorder, even in severe cases. Second, TNF-alpha may be a crucial cytokine in the pathogenesis of SFN in sarcoidosis and eventually also in other immune mediated inflammatory diseases.
Hoitsma
Elske
E
Dept. of Neurology, University Hospital Maastricht, The Netherlands.
Faber
Carin G
CG
van Santen-Hoeufft
Marijke
M
De Vries
Jolanda
J
Reulen
Jos P H
JP
Drent
Marjolein
M
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D001341:Autonomic Nervous System / Q000187:drug effects; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D000069285:Infliximab; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012507:Sarcoidosis / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D000069285:Infliximab