Thanks so much for your reply. I was dreading being told by my doctor that this is idiopathic or even worse, all in my head. So I felt hugely relieved when something showed up to be honest. I then forgot to ask my GP about the skin biopsy. I suspect they will say it isn't necessary now that the high immunoglobulin has been found and the SFN is my main symptom presently so this is enough proof for them. However I will certainly push for the reasons you outline. I have no issues with skin biopsies - have had some already from my neck for possible Lupus (equivocal). However it may take about 4 to 6 months to happen now because the dermatology department has huge waiting lists.

I think my RA has been knocked into the long grass by immune suppressant treatments now and could stay there forever if I'm very lucky - although this would be pretty rare for RA. Maybe it's too busy attacking my small fibers to bother with my joints? My tendons and soft tissue appear inflamed though.

But I'm guessing that the NHS won't be wanting to cover costs of IVIG unless there is shown to be no other way. So the fact that I have RA that may one day return might be used as a reason to wait and see. IVIG isnt used as a treatment for RA.

Just guessing here but for some reason my rheumatologist seems to be regarded as the key consultant over the neurologist (whom I like much more!) - and joints seem to be viewed as more important than connective tissue or nerves. I really cannot understand why unless it's because joints cost a lot of money to replace whereas nerves are irreplaceable?

Thanks for giving me some hope that I may one day get onto a proper immune therapy. Mat