IVIG Therapy for Autoimmune Small Fiber Neuropathy

Patient Characteristics and Treatment Response

• A 54-year-old female patient with a history of cancer and significant iron deficiency (low transferrin saturation) has been receiving IVIG every 28 days, with improvement in sensory symptoms, and rituximab every 6 months 1, 2

Treatment Approach and Efficacy

• For immune-mediated neuropathies, IVIG is typically dosed at 0.4 g/kg/day for 5 days (total dose 2 g/kg) for initial treatment, and for maintenance therapy, it is commonly administered at ≥1 g/kg every 4 weeks 3, 1
• The combination of IVIG with rituximab is supported for severe or refractory immune-mediated neurological conditions, and rituximab is considered if symptoms worsen or if there is no improvement after standard therapy 2, 4

Safety and Monitoring Considerations

• IVIG is generally well-tolerated, but patients with autonomic dysfunction may be more prone to developing aseptic meningitis or severe headaches, requiring careful administration 4
• Regular monitoring of anti-MAG antibody levels, neurological assessment, and potential adverse effects of IVIG is recommended 2, 4