Metyas Samy, Chen Christina, Quismorio Anne, Abdo Noor, Kamel Kevin
Covina Arthritis Clinic, Covina, California, CA, United States.
Curr Rheumatol Rev. 2020;16(4):280-284. doi: 10.2174/1573397115666191106120622.
Small fiber neuropathy and fibromyalgia are two conditions that share overlapping features. Although various treatments are available for use in fibromyalgia, the response often remains unsatisfactory. Prior studies have shown that in small fiber neuropathy of autoimmune etiology, intravenous immunoglobulin (IVIg) holds promise as an effective treatment.
Herein we report the use of IVIg in 7 patients who have both fibromyalgia and small fiber neuropathy. Skin punch biopsy evaluating the nerve fiber density was performed prior to diagnosis and after 6 months of IVIg therapy in each individual. Patients' symptoms were obtained via a fibromyalgia questionnaire pre- and post-treatment.
At the end of 6 months therapy, overall patients reported fewer fibromyalgia symptoms and skin biopsy demonstrated improvements as well. This retrospective pilot study suggests IVIg is a viable potential therapy in a subset of fibromyalgia patients who have small fiber neuropathy.
小纤维神经病变和纤维肌痛是两种具有重叠特征的病症。尽管有多种治疗方法可用于纤维肌痛，但治疗反应往往仍不尽人意。先前的研究表明，在自身免疫性病因引起的小纤维神经病变中，静脉注射免疫球蛋白（IVIg）有望成为一种有效的治疗方法。
在此，我们报告了7例同时患有纤维肌痛和小纤维神经病变的患者使用IVIg的情况。在每位患者诊断前及IVIg治疗6个月后，进行了评估神经纤维密度的皮肤打孔活检。通过纤维肌痛问卷在治疗前后获取患者的症状。
在6个月治疗结束时，总体患者报告的纤维肌痛症状减少，皮肤活检也显示出改善。这项回顾性试点研究表明，IVIg对于一部分患有小纤维神经病变的纤维肌痛患者是一种可行的潜在治疗方法。
