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Polyneuropathy associated with IgA monoclonal gammopathy of undetermined significance
Author(s) -
Simmons Zachary,
Bromberg Mark B.,
Feldman Eva L.,
Blaivas Mila
Publication year - 1993
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.880160113
Subject(s) - medicine , monoclonal gammopathy of undetermined significance , polyneuropathy , prednisone , gammopathy , sural nerve , peripheral neuropathy , biopsy , pathology , immunopathology , plasmapheresis , paraproteinemias , nerve biopsy , gastroenterology , monoclonal , immunology , antibody , monoclonal antibody , diabetes mellitus , endocrinology
Abstract Although polyneuropathies associated with IgM and IgG monoclonal gammopathies have been well described, polyneuropathy with IgA monoclonal gammopathy of undetermined significance (MGUS) is less commonly seen and has not been well studies. We reviewed the clinical and electrodiagnostic features of 5 such patients, and the sural nerve biopsy findings in 4 of them. One patient was diabetic, while 4 were free of other diagnoses commonly associated with neuropathy. Clinical presentations were varied. Electrodiagnostic and histological studies ranged from primary demyelination to primary axon loss to a mixed axonal/demyelinating picture. Three patients who were treated appeared to respond to prednisone or intravenous gamma globulin, despite clear clinical, electrodiagnostic, and histological differences. We conclude that the polyneuropathy associated with IgA MGUS is heterogeneous, similar to that in IgM and IgG MGUS. A trial of immunomodulating therapy appears to be warranted in such patients if the neuropathy is sufficiently servere. © 1993 John Wiley & Sons, Inc.