Immunochemical and clinical effects of immunosuppressive treatment in monoclonal IgM neuropathy.
A pathogenic role of the M protein in monoclonal IgM neuropathy has been suggested. This is based among other things on a close relation between immunosuppressive treatment, lowered concentration of M protein, and clinical effect. We studied five patients with monoclonal IgM and antibodies to peripheral nerve myelin. The immunosuppressive treatment was beneficial in three of the patients. In three patients there was a relationship between antibody concentration and clinical effect (in one there was no change in antibody concentrations and correspondingly no change in clinical status, and in two patients clinical improvement corresponded to decreased antibody concentrations). In two patients, however, there was no clear correlation, since one patient improved despite increasing antibody concentrations and one patient did not improve despite a lowered antibody concentration. It is therefore possible that other mechanisms may contribute to the effect of treatment.
D000328:Adult; D000368:Aged; D001798:Blood Proteins / Q000276:immunology*; D002699:Chlorambucil / Q000627:therapeutic use; D003711:Demyelinating Diseases / Q000188:drug therapy* / Q000276:immunology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis*; D007136:Immunoglobulins; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000188:drug therapy* / Q000276:immunology; D009185:Myelin Proteins / Q000276:immunology*; D018992:Myelin-Associated Glycoprotein; D009460:Neurologic Examination / Q000187:drug effects*; D010525:Peripheral Nerves / Q000276:immunology; D011129:Polyradiculoneuropathy / Q000188:drug therapy* / Q000276:immunology; D011239:Prednisolone / Q000627:therapeutic use; D009435:Synaptic Transmission / Q000187:drug effects / Q000502:physiology
D001798:Blood Proteins; D007075:Immunoglobulin M; D007136:Immunoglobulins; D007166:Immunosuppressive Agents; C009823:M-proteins (Myeloma); D009185:Myelin Proteins; D018992:Myelin-Associated Glycoprotein; D002699:Chlorambucil; D011239:Prednisolone; D008558:Melphalan