title: Extreme efficacy of intravenous immunoglobulin therapy for severe burning pain in a patient with small fiber neuropathy associated with primary Sjögren's syndrome.
abstract: Neurological involvement occurs in approximately 20% of patients with primary Sjögren's syndrome. Although neurological symptoms can affect the peripheral nervous system and the central nervous system, the most frequent symptom is polyneuropathy. Small fiber neuropathy (SFN) is a form of painful peripheral polyneuropathy that is common in patients with diabetic neuropathy, but may also occur in toxic, infectious, or immune-mediated neuropathy. We show here a patient with Sjögren's syndrome who developed SFN and was treated with intravenous immunoglobulin (IVIG) therapy, which was immediately and extremely effective. Because of the efficacy of IVIG therapy, we propose that direct immune-mediated mechanisms may be involved in the pathogenesis of SFN complicated by Sjögren's syndrome.
authors.affiliation: Department of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Wakasugi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kato
authors.forename: Takahisa
authors.initials: T
authors.lastname: Gono
authors.forename: Eiichi
authors.initials: E
authors.lastname: Ito
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nodera
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
authors.forename: Masako
authors.initials: M
authors.lastname: Hara
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D010147:Pain Measurement; D010292:Paresthesia / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D012859:Sjogren's Syndrome / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors