Acute painful autoimmune neuropathy: A variant of Guillain-Barré syndrome

Muscle Nerve. 2018 Feb;57(2):320-324. doi: 10.1002/mus.25738. Epub 2017 Jul 24.


Introduction: We present a painful small-fiber neuropathy variant of Guillain-Barré syndrome characterized by antecedent infectious symptoms, hyporeflexia, and albuminocytologic dissociation.

Methods: Two patients received intravenous immunoglobulin, one corticosteroids.

Results: The patients subsequently improved. Immunoglobulin G (IgG) antibodies in their acute phase sera strongly bound to murine small nerve fibers, and the binding disappeared during the convalescent phase. Serum transfer to a murine nociceptive model induced transient alteration in thermal pain responses.

Discussion: Our case series suggest that an acute transient immune response can be directed against small nerve fibers, and that patients so affected can exhibit features of Guillain-Barré syndrome. Muscle Nerve 57: 320-324, 2018.

Keywords: Guillain-Barré syndrome; acute onset; neuropathic pain; sensory neuropathy; small-fiber neuropathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Animals
  • Autoantibodies / pharmacology
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / pathology*
  • Female
  • Foot / innervation
  • Foot / pathology
  • Guillain-Barre Syndrome / drug therapy
  • Guillain-Barre Syndrome / pathology*
  • Humans
  • Immunization, Passive
  • Immunoglobulin G / immunology
  • Male
  • Mice
  • Nerve Fibers / pathology
  • Pain / drug therapy
  • Pain / pathology*
  • Pain Measurement
  • Small Fiber Neuropathy / drug therapy
  • Small Fiber Neuropathy / pathology*
  • Young Adult


  • Adrenal Cortex Hormones
  • Autoantibodies
  • Immunoglobulin G