Peripheral neuropathy in monoclonal gammopathy of undetermined significance: prevalence and immunopathogenetic studies
Authors:
- E. Nobile-OrazioENE. Nobile-Orazio
- S. BarbieriSBS. Barbieri
- L. BaldiniLBL. Baldini
- P. MarmiroliPMP. Marmiroli
- M. CarpoMCM. Carpo
- S. PremoselliSPS. Premoselli
- E. ManfrediniEME. Manfredini
- G. ScarlatoGSG. Scarlato
- 29 January 2009
- journal article
- Published by Wiley in Acta Neurologica Scandinavica
- Vol. 85 (6) , 383-390
Abstract
In an unselected series of patients with monoclonal gammopathy of undetermined significance (MGUS) we found neuropathy in 2 of 34 patients with IgG (6%), 2 of 14 with IgA (14%), and 8 of 26 with IgM MGUS (31%). The neuropathy was subclinical in 6 patients (1 IgG, 1 IgA, and 4 IgM). Patients with IgG or IgA MGUS had a prominent motor impairment with electrophysiologic and morphologic findings suggestive of predominant axonal degeneration. No deposit of the M-protein in sural nerve and no reactivity of the M-protein with nerve was detected in these patients. Patients with IgM MGUS had a prominent sensory impairment with evidence of predominant demyelination. In 6 of these patients the M-protein reacted with the myelin-associated glycoprotein (MAG). The higher prevalence of neuropathy in patients with IgM MGUS may be related to the frequent reactivity of IgM M-proteins with MAG.Keywords
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