Abstract:
:There are several pathogenic mechanisms of peripheral nerve involvement in patients with monoclonal dysglobulinemia. Intranervous proliferation of malignant cells, immunoglobulin, or amyloid deposits in the endoneurial space can only be determined by examination of nerve biopsy specimens. We present clinical, electrophysiological, and histological data from seven patients whose polyneuropathy was induced by immunoglobulin deposits in the endoneurial space. As these lesions cannot be demonstrated on clinical and electrophysiological grounds, the indication for nerve biopsy derives from careful analysis of each patient presenting with a polyneuropathy and a monoclonal dysglobulinemia. To visualize and clearly characterize these deposits, electron microscopic examination is indispensable. Immunocytochemical methods using both light and electron microscopy for ultrastructural analysis are of great value. Demonstration of endoneurial immunoglobulin deposits may have major therapeutic consequences. Indeed, identification of these deposits prompted the use of aggressive treatment, which was quite effective in five of our seven patients.
journal_name
Muscle Nervejournal_title
Muscle & nerveauthors
Vallat JM,Magy L,Richard L,Piaser M,Sindou P,Calvo J,Ghorab K,Cros Ddoi
10.1002/mus.21057subject
Has Abstractpub_date
2008-07-01 00:00:00pages
904-11issue
1eissn
0148-639Xissn
1097-4598journal_volume
38pub_type
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