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We developed a novel MRN protocol that can detect DRG abnormalities in SS patients with neuropathic pain who do not have markers of peripheral neuropathy. We found that SS patients with MRN DRG abnormalities had statistically significant, increased IENFD on skin biopsy studies, which may suggest a relationship between trophic mediators and neuropathic pain. Given that our literature review has demonstrated that many SS neuropathic pain patients do not have a neuropathy, our findings suggest an important niche for this MRN DRG technique in the evaluation of broader subsets of SS neuropathic pain patients who may not have underlying neuropathies. The improvement of MRN DRG abnormalities in patients with IVIg-induced remission of neuropathic pain suggests that our MRN protocol may be capturing reversible, immune-mediated mechanisms targeting the DRG. |
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algorithm gammaglobulin therapy,intravenous ganglionitis MRI,abnormal MRI,field strength,high MRI,peripheral nerve neurologic disease,diagnoses of pain pain,neuropathic sensory ganglia sensory ganglia,abnormal Sjogren's syndrome Sjogren's syndrome,neurologic manifestations of skin,biopsy
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