Cryptogenic small-fiber neuropathies: Serum autoantibody binding to trisulfated heparan disaccharide and fibroblast growth factor receptor-3

Todd D. Levine, Jafar Kafaie, Lawrence A. Zeidman, David S. Saperstein, Reyanna Massaquoi, Ruth J. Bland, Alan Pestronk

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

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.

Original languageEnglish
Pages (from-to)512-515
Number of pages4
JournalMuscle and Nerve
Volume61
Issue number4
DOIs
StatePublished - Apr 1 2020

Keywords

  • FGFR-3
  • TS-HDS
  • autoantibodies
  • pathogenesis
  • small-fiber neuropathy

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