Background: Small fiber neuropathy and fibromyalgia are two conditions that share
overlapping features. Although various treatments are available for use in fibromyalgia, the response
often remains unsatisfactory. Prior studies have shown that in small fiber neuropathy of
autoimmune etiology, intravenous immunoglobulin (IVIg) holds promise as an effective treatment.
Methods: Herein we report the use of IVIg in 7 patients who have both fibromyalgia and small fiber
neuropathy. Skin punch biopsy evaluating the nerve fiber density was performed prior to diagnosis
and after 6 months of IVIg therapy in each individual. Patients’ symptoms were obtained via
a fibromyalgia questionnaire pre- and post-treatment.
Results and Conclusion: At the end of 6 months therapy, overall patients reported fewer fibromyalgia
symptoms and skin biopsy demonstrated improvements as well. This retrospective pilot study
suggests IVIg is a viable potential therapy in a subset of fibromyalgia patients who have small fiber