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Immunofluorescence study of patients with neuropathy and IgM M proteins
Author(s) -
Takatsu Masami,
Hays Arthur P.,
Latov Norman,
Abrams Gary M.,
Nemni Raffaello,
Sherman William H.,
NobileOrazio Eduardo,
Saito Toyokazu,
Freddo Lorenza
Publication year - 1985
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410180203
Subject(s) - endoneurium , pathology , perineurium , sural nerve , immunofluorescence , polyneuropathy , medicine , nerve biopsy , pathogenesis , myelin , staining , immunoglobulin m , peripheral neuropathy , antigen , antibody , immunoglobulin g , immunology , endocrinology , anatomy , sciatic nerve , peripheral nerve , diabetes mellitus , central nervous system
Immunofluorescence histochemistry was used to study the pathogenesis of polyneuropathy in patients with an IgM M protein. Seventeen patients had an M protein that reacted with myelin‐associated glycoprotein (MAG), and their serum immunostained myelin sheaths of normal peripheral nerve of humans and certain other species. The staining was specific for the M protein idiotype and was abolished by prior absorption of serum with MAG. The sural nerve biopsy specimens from these 17 patients had pathological features of primary demyelination and deposits of IgM on the myelin sheaths. Sural nerve specimens of 2 patients with an M protein reactive with chondroitin sulfate showed axonal degeneration and diffuse deposits of IgM in the endoneurium. Serum of one of these patients immunostained connective tissue; the staining was specific for the M protein idiotype and was blocked by absorption of the serum with chondroitin sulfate. The antigenic specificity of the IgM M protein in another 9 patients with neuropathy is not known; however, sural nerve specimens obtained from some of the patients showed axonal degeneration and endoneurial deposits of IgM, and the serum IgM immunostained axons in some instances. The findings suggest that IgM M proteins may cause the neuropathy and that more than one autoantigen is involved.