[Polyneuropathies in monoclonal gammopathy of undetermined significance: initial manifestation of a lymphoma].
BACKGROUND
Monoclonal gammopathies-including so-called monoclonal gammopathies of undetermined significance-MGUS-may cause polyneuropathies, even if immunoglobulin concentrations are within a normal range.


METHODS
We report on a patient with a rapidly progressive polyneuropathy with severe motor disturbances in whom a small amount of a monoclonal IgM kappa cryoglobulin was found. Only by extensive, repeatedly performed diagnostic procedures could scattered lymphoma cells be detected. Nonspecific immunosuppression had been unsuccessful but eventually a more specific chemotherapy led to an almost complete, sustained recovery.


CONCLUSIONS
This case shows that in patients with a polyneuropathy of uncertain etiology monoclonal immunoglobulins should be looked for and that a MGUS can precede a lymphoma. Therefore these, patients with a MGUS and clinical deterioration despite conventional immunosuppressive treatment should undergo large-scale diagnostic check-up to make sure that the chance for an adequate chemotherapy is taken.
Drees
C
C
Klinik und Poliklinik für Neurologie und Psychiatrie der Universität zu Köln.
Grond
M
M
Szelies
B
B
Dietlein
M
M
Salzberger
B
B
Diehl
V
V
Heiss
W D
WD
D000368:Aged; D001853:Bone Marrow / Q000473:pathology; D003449:Cryoglobulinemia / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D007145:Immunoglobulin kappa-Chains / Q000097:blood*; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D010265:Paraproteinemias / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology
D007075:Immunoglobulin M; D007145:Immunoglobulin kappa-Chains
Schwerpunktpolyneuropathie bei monoklonaler Gammopathie unbestimmter Signifikanz (MGUS): Erstmanifestation eines Lymphoms.