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Neuropathy associated with immunoglobulin M monoclonal gammopathy: A combined sonographic and nerve conduction study
Author(s) -
Goedee H. Stephan,
Notermans Nicolette C.,
Visser Leo H.,
Asseldonk JanThies H.,
Franssen Hessel,
Vrancken Alexander F.J.E.,
Nikolakopoulos Stavros,
Berg Leonard H.,
Pol W. Ludo
Publication year - 2019
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26626
Subject(s) - medicine , chronic inflammatory demyelinating polyneuropathy , multifocal motor neuropathy , polyneuropathy , brachial plexus , median nerve , gammopathy , polyradiculoneuropathy , pathology , myelin , peripheral neuropathy , antibody , guillain barre syndrome , monoclonal , surgery , immunology , endocrinology , central nervous system , monoclonal antibody , mismatch negativity , electroencephalography , psychiatry , diabetes mellitus
We assessed the specific sonographic pattern of structural nerve abnormalities in immunoglobulin M (IgM) neuropathy and disease controls. Methods We enrolled 106 incident patients—32 patients with IgM neuropathy, 42 treatment‐naive patients with chronic inflammatory demyelinating polyneuropathy, and 32 patients with axonal neuropathies. All patients underwent standardized ancillary testing in addition to standardized sonography of the brachial plexus and the large arm and leg nerves bilaterally. Results We found widespread nerve enlargement in IgM neuropathy and chronic inflammatory demyelinating polyneuropathy (CIDP), with specific enlargement of brachial plexus and proximal segments of median nerve but not in axonal disease controls ( P < .001). Sonographic nerve hypertrophy in IgM neuropathy was not associated with nerve conduction, clinical, or laboratory characteristics. Discussion Immunoglobulin M neuropathy is characterized by widespread nerve enlargement indistinguishable from CIDP. Our data provide evidence to confirm that the disease process is not confined to the more distal parts of nerves in either classical demyelinating or axonal variants of neuropathy with associated IgM.