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October 26, 2022

Wieslab offers a new  Small Fiber Neuropathy panel for extended testing

Wieslab Laboratory Services is proud to be one of the first diagnostic laboratories in Scandinavia to offer an extended panel for Small Fiber Neuropathy (SFN) testing in serum.

In close collaboration with key healthcare professionals, we have developed an extended panel to support identifying the underlying SFN cause when there is no clear etiology.

Diabetes, sarcoidosis, hepatitis C, autoimmunity, Sjögren's syndrome, vitamin deficiency, toxic exposures, amyloidosis, paraneoplastic syndromes, and some rare genetic disorders have been reported as causes of SFN. However, the underlying cause is often unclear in a significant percentage of patients.

SFN can overlap with other muscle/pain syndromes and can be found in fibromyalgia, associated with muscle cramps and complex regional pain syndrome. SFN has been reported in up to 40% of patients with fibromyalgia.

Treatment of SFN is based on the primary cause. Determining the underlying cause for SFN in serum facilitates patient care.

October 26, 2022

Wieslab offers a new  Small Fiber Neuropathy panel for extended testing

Wieslab Laboratory Services is proud to be one of the first diagnostic laboratories in Scandinavia to offer an extended panel for Small Fiber Neuropathy (SFN) testing in serum.

In close collaboration with key healthcare professionals, we have developed an extended panel to support identifying the underlying SFN cause when there is no clear etiology.

Diabetes, sarcoidosis, hepatitis C, autoimmunity, Sjögren's syndrome, vitamin deficiency, toxic exposures, amyloidosis, paraneoplastic syndromes, and some rare genetic disorders have been reported as causes of SFN. However, the underlying cause is often unclear in a significant percentage of patients.

SFN can overlap with other muscle/pain syndromes and can be found in fibromyalgia, associated with muscle cramps and complex regional pain syndrome. SFN has been reported in up to 40% of patients with fibromyalgia.

Treatment of SFN is based on the primary cause. Determining the underlying cause for SFN in serum facilitates patient care.

ENGLISH

The new extended SFN panel includes novel inflammatory autoantibodies markers; TS-HDS; Plexin D1; SSA/Ro60; SSB (La); Transglutaminase IgA (TG2); CV2/CRMP5; PCA2; Fibroblast Growth Factor Receptor 3 (FGFR3); CASPR2.

New extended SFN panel:

  • TS-HDS (Trisulfated heparin disaccharide) antibodies are reported in a subgroup of patients with small fiber neuropathy (SFN) of unknown underlying cause. The onset of SFN associated with TS-HDS antibodies may be subacute.  
  • Plexin D1 antibodies have been detected in patients with burning pain and thermal hyperalgesia. The symptoms often respond to immunotherapies.  
  • SSA/Ro60 antibodies are markers for Sjogren’s syndrome and systemic lupus erythematosus but can also be seen in other rheumatic systemic diseases.  
  • SSB (La) antibodies occur almost always in conjunction with anti-SSA and are frequently found in primary Sjogren’s syndrome and systemic lupus erythematosus.   
  • Transglutaminase IgA (TG2) is a strong diagnostic marker for celiac disease. SFN and sensory disturbances can precede the diagnosis of celiac disease.  
  • CV2/CRMP5 antibodies are paraneoplastic markers primarily associated with small cell lung cancer but may also be associated with other types of tumors. Clinical symptoms may be chorea, sensorimotor neuropathy, limbic encephalitis, and cerebellar degeneration.   
  • PCA2 antibodies, the Purkinje cell antigen 2 antibodies are primarily associated with cancer in breast, ovary, and lung (SCLC). Encephalomyelitis, ataxia and cerebellar degeneration are typical. SFN has also been reported but seems to be rare.  
  • Fibroblast Growth Factor Receptor 3 (FGFR3) antibodies have been reported in patients with autoimmune diseases and concomitant sensory neuropathy. 
  • CASPR2 antibodies,  Contactin Associated Protein 2 (CASPR2) is an extracellular antigen and a subunit of the potassium channel complex (VGKC). Antibodies against CASPR2 have been reported in patients with SFN, neuromyotonia, autoimmune encephalitis, and Morvan Syndrome.   

SVENSKA

Den nya utökade SFN-panelen inkluderar nya inflammatoriska autoantikroppsmarkörer; TS-HDS; Plexin Dl; SSA/Ro60; SSB (La); transglutaminas IgA (TG2); CV2/CRMP5; PCA2; Fibroblasttillväxtfaktorreceptor 3 (FGFR3); CASPR2.

Följande autoantikroppar ingår i denna panel: 

  • TS-HDS (Trisulfated heparin disaccharide) antikroppar rapporteras i en subgrupp av patienter med fintrådsneuropati (SFN) med okända bakomliggande orsaker. Debut med SFN associerad med TS-HDS antikroppar kan vara subakut.  
  • Plexin D1-antikroppar kan påvisas hos en del patienter med neuropatisk smärta. Brännande smärta och värmeöverkänslighet typiskt och symtomen svarar ofta på immunterapi.  
  • SSA/Ro60-antikroppar förekommer, speciellt vid Sjögrens Sjögrens syndrom och systemisk lupus erythematosus men kan även ses vid andra reumatiska sjukdomar.   
  • SSB (La)-antikroppar förekommer mycket ofta i samband med anti-SSA och ses framför allt vid Sjögrens Sjögrens syndrom och systemisk lupus erythematosus.   
  • Transglutaminas IgA (TG2) antikroppar är en stark diagnostisk markör för celiaki. Fintrådsneuropati kan föregå celiaki diagnos.  
  • CV2/CRMP5-antikroppar är en paraneoplastisk markör som i första hand är associerad med småcellig lungcancer, men kan även förekomma vid andra tumörtyper. Kliniska symtom kan vara chorea, sensorimotorisk neuropati, limbisk encefalit och cerebellär degeneration.  
  • PCA2-antikroppar, Purkinje cellantigen 2 antikroppar är främst associerade med cancer i bröst, äggstockar och lunga (SCLC). Encefalomyelit, ataxi och cerebellär degeneration är typiskt. SFN har rapporterats, men förefaller vara ovanligt.
  • Fibroblast Growth Factor Receptor 3 (FGFR3) antikroppar har rapporterats hos patienter med autoimmuna sjukdomar och samtidig sensorisk neuropati.   
  • CASPR2-antikroppar, Contactin Associated Protein (CASPR2) utgör en subenhet av kaliumkanalkomplexet (VGKC) och ingår i gruppen extracellulära antigener. Antikroppar mot CASPR2 kan förekomma hos patienter med SFN, neuromyotoni, autoimmun encefalit samt Morvans syndrom.

View panel 539 - Extended panel SFN

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Se panel 539 -  Utökad panel Fintrådsneuropati

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References:

  • Zeidman LA. Advances in the Management of Small Fiber Neuropathy. Neurol Clin. 2021 Feb;39(1):113-131. doi: 10.1016/j.ncl.2020.09.006. Epub 2020 Nov 7. PMID: 33223078.