Hoitsma Elske, Faber Carin G, van Santen-Hoeufft Marijke, De Vries Jolanda, Reulen Jos P H, Drent Marjolein
Dept. of Neurology, University Hospital Maastricht, The Netherlands.
Sarcoidosis Vasc Diffuse Lung Dis. 2006 Mar;23(1):73-7.
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.
我们描述了一名患有严重小纤维神经病变（SFN）并伴有自主神经受累的患者，该患者接受了英夫利昔单抗（一种抗肿瘤坏死因子-α（TNF-α）疗法）的试验性治疗。开始这种治疗六个月后，他的症状完全消失。到目前为止，症状未再复发。经过一年的治疗，重复温度阈值测试（TTT）以及心血管自主神经功能测试明显改善。该病例揭示了两个重要问题。首先，它表明SFN似乎不是一种不可逆的疾病，即使在严重病例中也是如此。其次，TNF-α可能是结节病中SFN发病机制中的关键细胞因子，最终在其他免疫介导的炎症性疾病中也是如此。
