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.
© 2017 Wiley Periodicals, Inc.