Cryptogenic small‐fiber neuropathies: Serum autoantibody binding to trisulfated heparan disaccharide and fibroblast growth factor receptor‐3. Issue 4 (6th November 2019)

• Record Type: Journal Article
• Authors: Levine, Todd D.; Kafaie, Jafar; Zeidman, Lawrence A.; Saperstein, David S.; Massaquoi, Reyanna; Bland, Ruth J.; Pestronk, Alan
• Is Part Of: Muscle & nerve. Volume 61:Issue 4(2020)
• Page Start: 512
• Page End: 515
• Publication Date: 2019-11-06
• Subjects: autoantibodies -- FGFR‐3 -- pathogenesis -- small‐fiber neuropathy -- TS‐HDS; Neuromuscular diseases -- Periodicals; Muscles -- Periodicals; Nerves -- Periodicals; 616.74
• DOI: 10.1002/mus.26748
• Languages: English
• ISSNs: 0148-639X

Abstract

Abstract: Introduction: Causes of small‐fiber peripheral neuropathies (SFN) are often undefined. In this study we investigated associations of serum autoantibodies, immunoglobulin G (IgG) vs fibroblast growth factor receptor‐3 (FGFR‐3), and immunoglobulin M (IgM) vs trisulfated heparan disaccharide (TS‐HDS) in cryptogenic SFN. Methods: One hundred fifty‐five patients with biopsy‐proven SFN and no identified cause for their neuropathy were blindly tested for serum IgM vs TS‐HDS and IgG vs FGFR‐3. Results: Forty‐eight percent of SFN patients had serum antibodies, 37% with IgM vs TS‐HDS and 15% with IgG vs FGFR‐3. TS‐HDS antibodies were more frequent in SFN patients than in controls ( P = .0012). Both antibodies were more common in females, and with non–length‐dependent nerve pathology. Nintey‐two percent of patients with acute‐onset SFN had serum IgM vs TS‐HDS. Discussion: Autoantibodies directed against TS‐HDS and FGFR‐3 suggest an immune disorder in otherwise idiopathic SFN. Serum IgM vs TS‐HDS may be a marker for SFN with an acute onset. Abstract : See editorial on pages 433–435 in this issue .