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

Background: Patients with painful sensory neuropathy associated with Sjogren'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 Sjogren's syndrome. Patients and methods: We examined 5 patients affected by painful sensory neuropathy associated with Sjogren'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% front 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 Sjogren's syndrome-associated neuropathy. Further studies should be done in a controlled, blind study. (C) 2008 Elsevier B.V. All rights reserved.