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Peripheral neuropathy in monoclonal gammopathy of undetermined significance: prevalence and immunopathogenetic studies
Author(s) -
NobileOrazio E.,
Barbieri S.,
Baldini L.,
Marmiroli P.,
Carpo M.,
Premoselli S.,
Manfredini E.,
Scarlato G.
Publication year - 1992
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1992.tb06033.x
Subject(s) - monoclonal gammopathy of undetermined significance , medicine , subclinical infection , gammopathy , peripheral neuropathy , pathology , sural nerve , immunopathology , immunology , immunoglobulin a , monoclonal , antibody , immunoglobulin g , monoclonal antibody , endocrinology , diabetes mellitus
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.