A controlled study of intravenous immunoglobulin in demyelinating neuropathy with IgM gammopathy.
Eleven patients with demyelinating polyneuropathy associated with monoclonal IgM antibodies were randomized to receive IVIg or placebo, monthly, for 3 months in a double-blind study. After a washout period, they crossed over to the alternate therapy. Response was gauged by evaluating muscle strength, sensation, and neuromuscular symptoms at baseline, after 3 months, and at treatment's end. After IVIg therapy, the strength improved in only 2 of 11 patients, by 28 and 38.5 points from baseline, and declined after placebo. In 1 other patient, the sensory score improved by 13 points. Antibody titers to MAG/SGPG or gangliosides did not appreciably change. We conclude that IVIg has only a modest benefit to not more than 18% of patients with IgM paraproteinemic demyelinating neuropathy.
Dalakas
M C
MC
Neuromuscular Diseases Section, Laboratory of Molecular and Cellular Neurobiology, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1382, USA.
Quarles
R H
RH
Farrer
R G
RG
Dambrosia
J
J
Soueidan
S
S
Stein
D P
DP
Cupler
E
E
Sekul
E A
EA
Otero
C
C
D017668:Age of Onset; D000368:Aged; D000917:Antibody Formation; D001323:Autoantibodies / Q000097:blood*; D018592:Cross-Over Studies; D003711:Demyelinating Diseases / Q000150:complications / Q000276:immunology / Q000628:therapy*; D005260:Female; D005915:Globosides / Q000276:immunology; D006017:Glycolipids / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D010919:Placebos
D001323:Autoantibodies; D005915:Globosides; D006017:Glycolipids; D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous; D010919:Placebos; C051917:sulfate-3-glucuronyl paragloboside