title: [Polyneuropathies in monoclonal gammopathy of undetermined significance: initial manifestation of a lymphoma].
abstract: 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.
authors.affiliation: Klinik und Poliklinik für Neurologie und Psychiatrie der Universität zu Köln.
authors.forename: C
authors.initials: C
authors.lastname: Drees
authors.forename: M
authors.initials: M
authors.lastname: Grond
authors.forename: B
authors.initials: B
authors.lastname: Szelies
authors.forename: M
authors.initials: M
authors.lastname: Dietlein
authors.forename: B
authors.initials: B
authors.lastname: Salzberger
authors.forename: V
authors.initials: V
authors.lastname: Diehl
authors.forename: W D
authors.initials: WD
authors.lastname: Heiss
mesh_terms: 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
chemical_list: D007075:Immunoglobulin M; D007145:Immunoglobulin kappa-Chains
vernacular_title: Schwerpunktpolyneuropathie bei monoklonaler Gammopathie unbestimmter Signifikanz (MGUS): Erstmanifestation eines Lymphoms.