21. What is Small Fiber Neuropathy?

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Small fiber neuropathy is a type of peripheral neuropathy in which the small nerve endings in the skin of the feet and legs become damaged.  The diagnosis of small fiber neuropathy is made when a biopsy of the skin is taken and shows decreased density of the small nerve fibers (see section 22).

Many peripheral neuropathies are associated with small fiber neuropathy. The following is a partial list of diseases that may cause a small fiber neuropathy:

Diabetes, prediabetes, excessive and chronic alcohol consumption, vitamin B1 deficiency, vitamin B12 deficiency, hyperlipidemia (increased cholesterol and triglycerides), thyroid disease, amyloidosis, Fabry syndrome, celiac disease, sarcoidosis, human immunodeficiency virus (HIV) infection, hepatitis C virus infection, connective tissue disease, paraproteinemia, restless legs syndrome, toxic drug exposure, hereditary diseases, paraneoplastic syndrome and Sjögren disease.

If you have been diagnosed with small fiber neuropathy you should discuss with your physician the possibility that any of these diseases may be the cause.

Questions and Answers About Peripheral Neuropathy ​

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THIS SITE IS WRITTEN BY A PHYSICIAN WHO SPECIALIZES IN THE TREATMENT OF PERIPHERAL NEUROPATHY.

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