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To identify novel autoantibodies in small-fiber neuropathy, 59 adult patients diagnosed with presumed idiopathic small-fiber neuropathy and 20 healthy controls were enrolled at an institution in Singapore. Most (74.1%) patients met definite diagnostic criteria for small-fiber neuropathy based on a combination of symptoms, signs, and either intraepidermal nerve fiber density (62.1%), or quantitative sensory testing (12%). Secondary causes were found in 41% of patients. The investigators used a novel protein microarray platform of >1600 antigens to screen participants' serum for antibodies in their native conformational state.
Levels of 11 proteins were significantly higher in patients with both idiopathic and secondary small-fiber neuropathy …