Intravenous immunoglobulin treatment for painful sensory neuropathy associated with Sjögren's syndrome

J Neurol Sci. 2009 Apr 15;279(1-2):57-61. doi: 10.1016/j.jns.2008.12.018. Epub 2009 Jan 24.

Abstract

Background: Patients with painful sensory neuropathy associated with Sjögren's syndrome-associated neuropathy often show severe neuropathic pain which is not relieved by conventional treatments.

Objective: To evaluate the effect of intravenous immunoglobulin (IVIg) therapy in the treatment of neuropathic pain associated with Sjögren's syndrome.

Patients and methods: We examined 5 patients affected by painful sensory neuropathy associated with Sjögren's syndrome. All patients were treated with IVIg (0.4 g/kg/day for 5 days) and pain rating was assessed by the Visual Analogue Scale (VAS).

Results: All five patients showed a remarkable improvement in neuropathic pain following IVIg therapy. Pain, assessed by the determination of mean VAS score, was reduced by 73.4% from days 2-14 following treatment. The observed clinical improvement persisted for 2 to 6 months. One patient, examined by quantitative sensory testing (QST), showed an improvement of superficial sensory deficit accompanied by pain relief.

Conclusion: IVIg might be an effective treatment for pain in Sjögren's syndrome-associated neuropathy. Further studies should be done in a controlled, blind study.

MeSH terms

  • Aged
  • Analgesics, Non-Narcotic / therapeutic use*
  • Disease Progression
  • Female
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Male
  • Median Nerve / physiopathology
  • Middle Aged
  • Neural Conduction
  • Pain / drug therapy*
  • Pain / etiology
  • Pain Measurement
  • Peripheral Nervous System Diseases / complications
  • Peripheral Nervous System Diseases / physiopathology*
  • Sjogren's Syndrome / physiopathology*
  • Sural Nerve / pathology
  • Sural Nerve / physiopathology
  • Tibial Nerve / physiopathology
  • Treatment Outcome

Substances

  • Analgesics, Non-Narcotic
  • Immunoglobulins, Intravenous