What is the importance of finding a positive titer for TS-HDS and what treatment would be advised for these patients?

TS-HDS antibodies were first described by investigators from Washington University in St. Louis (2003) in five patients with painful sensory axonal neuropathy [1]. Further studies by the same group indicated that TS-HDS antibodies were associated with prominent neuropathic pain in the upper extremities, and findings that MAY suggest an immune-mediated pathology, including thickened capillaries and complement deposition in capillaries seen in nerve biopsy samples (see comments below) and IgM deposition in nerve biopsy [2].

More recent studies in larger patient populations, again, by the same group, suggested that TSHDS antibodies are more likely to be detected in acute onset small fiber neuropathies and non-length dependent sensory neuronopat...

Over a year later, I think Dr. @Dr. First Last' answer still holds true and remains a wonderful overview of this topic. I will add that what is said about TS-HDS can be said about GALOP, Beta-tubulin, Histone H3, and sulfatide, all of which are part of the Wash U sensorimotor panel for years without corroborating evidence of clinical significance from other labs or even with clarity from Wash U.

While some of the antibodies on the panel are of interest (anti-MAG, GD1b, and GQ1b), the whole panel is not helpful and leads clinicians to treat immune-mediated diseases based on very shaky associations.

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I thank Dr. @Dr. First Last for this comprehensive analysis of the data. Here's my skeptical (cynical) tak...