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Microvasculitic paraproteinaemic polyneuropathy and B‐cell lymphoma
Author(s) -
Turner Martin R.,
Warren Jason D.,
Jacobs Jean M.,
Groves Mike J.,
Yong Kwee,
Honan William P.,
Thomas P. K.,
Reilly And Mary M.
Publication year - 2003
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1046/j.1529-8027.2003.03013.x
Subject(s) - medicine , pathology , mononeuritis multiplex , bone marrow , pathogenesis , lymphoma , disease , vasculitis
Microvasculitis may play a greater part in the pathogenesis of paraproteinaemic neuropathies than is generally recognised, producing tissue destruction by convergent immune and physical mechanisms. We present a patient with a clinical syndrome of mononeuritis multiplex and a circulating IgM lambda paraprotein, in whom bone marrow aspiration revealed a lymphoplasmacytoid lymphoma. Microvasculitic changes were present in the first nerve biopsy, and the second showed extensive destruction of neural architecture and deposition of IgM‐related material. A 2‐stage pathogenic cascade is postulated and explored with a review of the relevant literature.