TY - JOUR
T1 - The incidental finding of elevated anti GQ1B antibodies in a patient with selective small fiber neuropathy
AU - Favoni, Valentina
AU - Liguori, Rocco
AU - Incensi, Alex
AU - Fileccia, Enrico
AU - Donadio, Vincenzo
N1 - "Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Liguori Rocco)"
PY - 2018/5/15
Y1 - 2018/5/15
N2 - Small fiber neuropathy (SFN) selectively affects small diameter sensory and/or autonomic axons. Pain and autonomic dysfunctions are the most common symptoms. SFN occurs in several autoimmune diseases and autoantibodies against neuronal proteins may play a role in SFN pathophysiology. Anti-GQ1b antibody has been associated with Miller Fisher syndrome, Bickerstaff's brainstem encephalitis, acute ophthalmoplegia, pharyngeal-cervical-brachial weakness and peripheral neuropathy involving large fibers. Isolated SFN associated with anti-GQ1b antibodies has not been previously reported. Here we report a 45-year-old woman presenting with highly positive anti-GQ1b titer and selective SFN without central nervous system or peripheral large nerve involvement. She improved upon administration of adalizumab. Further studies will clarify a possible pathogenetic role of antiganglioside antibodies in SFN. Moreover, the recognition of antiganglioside antibodies in SFN may have therapeutic consequences with patients who would benefit from immunotherapy.
AB - Small fiber neuropathy (SFN) selectively affects small diameter sensory and/or autonomic axons. Pain and autonomic dysfunctions are the most common symptoms. SFN occurs in several autoimmune diseases and autoantibodies against neuronal proteins may play a role in SFN pathophysiology. Anti-GQ1b antibody has been associated with Miller Fisher syndrome, Bickerstaff's brainstem encephalitis, acute ophthalmoplegia, pharyngeal-cervical-brachial weakness and peripheral neuropathy involving large fibers. Isolated SFN associated with anti-GQ1b antibodies has not been previously reported. Here we report a 45-year-old woman presenting with highly positive anti-GQ1b titer and selective SFN without central nervous system or peripheral large nerve involvement. She improved upon administration of adalizumab. Further studies will clarify a possible pathogenetic role of antiganglioside antibodies in SFN. Moreover, the recognition of antiganglioside antibodies in SFN may have therapeutic consequences with patients who would benefit from immunotherapy.
KW - Anti-GQ1b
KW - Autoimmune diseases
KW - Skin biopsy
KW - Small fiber neuropathy
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U2 - 10.1016/j.jns.2018.03.030
DO - 10.1016/j.jns.2018.03.030
M3 - Letter
C2 - 29627021
AN - SCOPUS:85044476507
VL - 388
SP - 192
EP - 194
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
ER -