The spectrum of autoimmune disorders in chronic immune-mediated neuropathies.

Abstract

Introduction: Autoimmune disorders frequently cluster within individuals, a phenomenon known as polyautoimmunity, yet its scope and implications in chronic immune-mediated neuropathies remain underexplored.

Areas covered: This review examines the association between chronic immune-mediated neuropathies and broader systemic autoimmunity to highlight the immunopathological mechanisms driving these associations, and clinical implications for diagnosis, prognosis, and treatment. A comprehensive literature search was conducted using PubMed and Embase databases for studies published up to October 2025 employing terms related to autoimmune neuropathies, polyautoimmunity, and associated systemic autoimmune diseases.

Expert opinion: While autoimmune comorbidities in CIN are often viewed as confounding conditions for diagnosis, they may indicate a broader, systemic immune dysregulation. Adopting this perspective has direct clinical relevance. Proactive screening for associated autoimmune disorders is essential, as their presence can shape disease trajectory and modify treatment responsiveness. Furthermore, uncovering shared pathological pathways between CIN and these coexisting conditions may open avenues for therapeutic strategies that simultaneously target both neuropathic and systemic manifestations. To advance this field, future research may allow discovery of biomarkers that could stratify patients based on their distinct underlying immune drivers, which may pave the way for a precision medicine approach in this clinically heterogeneous population.