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Could Small Fiber Neuropathy Be Cytokine Rather Than Autoantibody Mediated?


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This may be of interest. Small fiber neuropathy and many idiopathic neuropathies have traditionally been thought to be mediated by an autoimmune process. But some research suggests that perhaps they are the result of cytokine inflammation similar to Rheumatoid Arthritis and other inflammatory disorders - inflammation of the nerves in this case. With the possibility of viable treatments:

http://www.ncbi.nlm.nih.gov/pubmed/20513817

http://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=2&sqi=2&ved=0CGgQFjAB&url=http%3A%2F%2Fildcare.nl%2FDownloads%2Fartseninfo%2FHoitsma%2520et%2520al.%2520Infliximab%2520in%2520SFN%25202006%2520Sar%2520Vasc%2520Diffuse%2520Lung%2520Dis%25202006.pdf&ei=XKrRT6GGFYrdmAXyz4H9Ag&usg=AFQjCNGz4iRGulirmR4WXhoxhnUyqT8wjQ&sig2=AUKgd-148BhHrly5KNUykQ

http://www.springerlink.com/content/d4147313131mqg4t/

This may be of interest in those with neuropathic POTS or those that have other autonomic neuropathies. Basically cytokine mediated inflammation could actually be treated with TNF alpha inhibiting medications.

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Its interesting that about 33% of POTSies have small fiber neuropathy involving sensory symptoms, while others only effecting autonomic control. Yet only a much smaller group test positive for ACHr receptor autoantibodies and many POTSies have elevated inflammatory markers like C Reactive protein.

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I tested negative for AChR antibodies but was diagnosed with a sensory neuropathy. Very interesting!!! Never had my TNF alpha or IL-2 levels checked....

Good articles!
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Good articles. Explains the connections I think. Since my dad has AS and also severe neuropathies (that seem to be a genetically inherited problem) and also has Gallium Barre - the connections seem to be there. His neuropathies have definitely progressed to the large fibers and he has no feeling in his legs - up to above his thighs and in his arms above his elbows. He is nearly incapacitated by this and has a whole lot of pain with it - despite having numbness. I think possibly some genetic components are at play here - because his father had the same issues and unfortunately - I seem to be following in their footsteps. The second article listed above talks about sarcoidosis and I have genetic markers for that and I also have some type of small tumors all over me (like lipomas or granulomas) both in organs and some that can be felt just under the skin and most have enlarged. They have never been biopsied to see if its sarcoidosis - so don't know. I'm right now having a tumor check going on to see how the internal ones on organs are. Doc. wants me to see specialist in regards to one on liver (it's been there for a few years.) And they found something on one kidney and lots in thyroid (one bioposied because they thought it might be cancer - thank goodness, wasnt. My dad also had thyroid cancer. Oh, all these lovely genetics. NOT! :( So, more testing to follow. Sigh! I hate this part of the answer trail - the testing part. Waiting for more test results.

http://en.wikipedia.org/wiki/Sarcoidosis

Interesting find Rama and maybe can give us another part of the puzzle to take a look at.

Issie

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I was tested for Sarcoidosis, but not small fiber neuropathy...Negative on the Sarcoidosis. Issie, I mentioned Sarcoidosis on a previous post to you to see if you had been tested. Glad that you are testing for that. Sorry about your family history, mines not good either :(

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I was tested for Sarcoidosis, but not small fiber neuropathy...Negative on the Sarcoidosis. Issie, I mentioned Sarcoidosis on a previous post to you to see if you had been tested. Glad that you are testing for that. Sorry about your family history, mines not good either :(

Thanks Kim. I guess, I don't remember that . . .but, thank you. I think it's definitly worth looking into. Yeah, with the new genetic testing I recently did - I'm finding out a whole lot of things. Some things I wish I didn't know . . .just have to hope that the possiblities don't happen. Just because you have the genes for something - doesn't mean something will trigger it in you and it will be a problem for you. But, I'm getting some definite answers and I'm so excited about what I'm learning.

Issie

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Thanks for the post Rama!

Glad you are getting answers Issie. It was a post when you were mentioning the growths that they were finding in various organs, but I can't remember which one. It's been months ago now!

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  • 3 weeks later...

I recently asked my doc. for testing on cytokines. I remembered something being here and couldn't find it recently - asking some questions because of some positive markers on autoimmune disorders. I did a search on google and found this thread again.

Maybe something we should take a look at.

Issie

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I asked my immunologist about testing TNF alpha and he said the test is not an accurate reflection of what's going on. He was in a hurry that day so I couldn't get a more complete explanation. I think I'll ask again another time.

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I asked my immunologist about testing TNF alpha and he said the test is not an accurate reflection of what's going on. He was in a hurry that day so I couldn't get a more complete explanation. I think I'll ask again another time.

unfortunately your doctor is right. Plasma levels of cytokines dont actually show whats going on at local levels - in ank spond and other crohns TNF alpha levels can be normal in blood, but elevated at the site specific target, meaning a biospy would be the only way to go.

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I'm not giving up in having my cytokines tested. I still want to know. If something shows up - it may be more parts of the puzzle. There may be a lot of false negatives ----but, there probably wont be any false positives. :)

Issie

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  • 2 months later...
Guest mattgreen

Its interesting that about 33% of POTSies have small fiber neuropathy involving sensory symptoms, while others only effecting autonomic control. Yet only a much smaller group test positive for ACHr receptor autoantibodies and many POTSies have elevated inflammatory markers like C Reactive protein.

Would low/normal serum CRP rule out cytokine inflammation?

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This is all so very interesting to me. I have an elevated TNF at 15X upper level or normal which was drawn during my MCAS workup. There are a few of us that have had TNF drawn by our various mast cell specialists or immunolgists who are pretty versed in mast cell disorders. I also have autonomic neuropathy of both my CV and sudomotor systems, and this is a pretty decent and convincing angle for me to link the two disorders, as most of the MCAS patients out there have POTS.

Not sure if any of you saw this, but as I have been trying to link the massive inflammation back to my current issues, I ran across this link on GMO (genetically modified foods ) in the US food supply. It is a pretty compelling movie, and horrifying to see what we are eating here.

http://articles.mercola.com/sites/articles/archive/2012/09/15/genetic-roulette-gmo-documentary.aspx

Thanks for sharing, Rama.

Lyn

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