Axonal neuropathy in a patient with monoclonal IgM kappa reactive with Schmidt-Lantermann incisures.
We report a patient with a progressive, predominantly sensory neuropathy and a IgM kappa M-protein that binds to Schmidt-Lantermann incisures. A sural nerve biopsy showed primary axonal damage and IgM deposits at Schmidt-Lantermann incisures were seen by direct immunoperoxidase. Serum from the patient injected into rat sciatic nerve reacts with the incisures as with those in the patient's nerve. The IgM kappa M-protein reacts with chondroitin sulfate C and binds to a broad nerve protein band with a mobility of between 170 and 118 kDa. Peripheral neuropathy may be related to the M-protein, which had immunocytochemical reactivity not previously described for patients with polyneuropathy and IgM monoclonal gammopathy.
Quattrini
A
A
Department of Neurology, University of Milan, Istituto Scientifico S. Raffaele, Italy.
Nemni
R
R
Fazio
R
R
Iannaccone
S
S
Lorenzetti
I
I
Grassi
F
F
Canal
N
N
D001369:Axons / Q000473:pathology*; D001798:Blood Proteins / Q000276:immunology*; D002809:Chondroitin Sulfates / Q000032:analysis; D006801:Humans; D015151:Immunoblotting; D007075:Immunoglobulin M / Q000032:analysis*; D007145:Immunoglobulin kappa-Chains / Q000032:analysis*; D007136:Immunoglobulins; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000276:immunology*; D010523:Peripheral Nervous System Diseases / Q000276:immunology* / Q000473:pathology; D013497:Sural Nerve / Q000473:pathology
D001798:Blood Proteins; D007075:Immunoglobulin M; D007145:Immunoglobulin kappa-Chains; D007136:Immunoglobulins; C009823:M-proteins (Myeloma); D002809:Chondroitin Sulfates