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Clinical features and anti-neural reactivity in neuropathy associated with IgG monoclonal gammopathy of undetermined significance.

Abstract：

:Neuropathy has been frequently reported in patients with IgG monoclonal gammopathy of undetermined significance (MGUS) but it is still unclear whether this association has clinical or pathogenetic relevance. In order to clarify the possible role of IgG MGUS in the neuropathy we correlated the clinical and electrophysiological features of the neuropathy with the duration and anti-neural activity of the M-protein in 17 patients with neuropathy and IgG MGUS. Ten patients (59%) had a chronic demyelinating neuropathy clinically indistinguishable from chronic inflammatory demyelinating polyneuropathy (CIDP) while 7 (41%) had a predominantly sensory axonal or mixed neuropathy. In 80% of patients in the CIDP-like and 28% in the sensory group the IgG M-protein became manifest several months to years after onset of the neuropathy. Antibodies to one or more neural antigens (including tubulin, a 35KD P0-like nerve myelin glycoprotein, GD1a, GM1 and chondrotin sulfate C) were found in 40% of patients with CIDP-like and 43% with sensory neuropathy but also in 37% patients with IgG MGUS without neuropathy. Neuropathy associated with IgG MGUS is probably less heterogeneous than previously considered suggesting that this association may not be merely casual. The evidence for primary pathogenetic role of IgG M-proteins in the neuropathy remains however elusive.

journal_name

J Neurol Sci

journal_title

Journal of the neurological sciences

authors

Di Troia A,Carpo M,Meucci N,Pellegrino C,Allaria S,Gemignani F,Marbini A,Mantegazza R,Sciolla R,Manfredini E,Scarlato G,Nobile-Orazio E

doi

10.1016/s0022-510x(99)00049-0

subject

Has Abstract

pub_date

1999-03-15 00:00:00

pages

64-71

issue

1

eissn

0022-510X

issn

1878-5883

pii

S0022-510X(99)00049-0

journal_volume

164

pub_type

杂志文章

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