Toxins can lead to this condition. Several toxins, including alcohol, arsenic
and metronidazole (an antibiotic) preferentially affect small fibers.
The other known causes of small-fiber neuropathy include diabetes mellitus or glucose intolerance, amyloidosis, toxins, inherited sensory and autonomic neuropathies, Sjogren’s syndrome, lupus, sarcoid, nutritional deficiencies, celiac disease, hereditary conditions including Fabry disease and Guillain-Barre syndrome.