Polyneuropathy associated with IgA monoclonal gammopathy: a hypothesis of its pathogenesis.
We describe three patients with chronic progressive polyneuropathy associated with IgA monoclonal gammopathy. Two patients had a prominent sensory neuropathy and one had a prominent motor neuropathy. Sural nerve biopsies showed axonal degeneration in all cases. In immunocytochemical studies patients' IgG immunostained axons. By Western immunoblot a band of IgG reactivity with an axonal protein of 66 kDa was found. No band of IgA and IgM were found. We suggest the possibility that the IgA monoclonal protein may act as a stimulating factor of preexisting B cell clones eliciting an immune reaction against nerve antigens.
Nemni
R
R
Department of Neurology, University of Milan, S. Raffaele Hospital, Italy.
Mamoli
A
A
Fazio
R
R
Camerlingo
M
M
Quattrini
A
A
Lorenzetti
I
I
Comola
M
M
Galardi
G
G
Canal
N
N
D000368:Aged; D015153:Blotting, Western; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis*; D007074:Immunoglobulin G / Q000032:analysis*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D010265:Paraproteinemias / Q000150:complications* / Q000276:immunology / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D013497:Sural Nerve / Q000276:immunology / Q000473:pathology
D007070:Immunoglobulin A; D007074:Immunoglobulin G