Peripheral neuropathy associated with IgM monoclonal gammopathy: correlations between M-protein antibody activity and clinical/electrophysiological features in 40 cases.
Forty cases of polyneuropathy associated with IgM monoclonal gammopathy were retrospectively studied to investigate the relevance of clinical and electrophysiological features to M-protein antibody activity. There were 26 men and 14 women; mean age was 65 +/- 11.7 years at the time of the study. Thirty-nine patients had a symmetrical polyneuropathy, of whom 13 had a predominantly sensory and 17 a purely sensory neuropathy (i.e., 30 sensory neuropathies). The remaining patient had a multifocal mononeuropathy. Electrophysiological studies allowed the polyneuropathies to be classified as demyelinating in 33 cases (82.5%) and axonal in 6 cases. Antibody studies disclosed anti-MAG antibodies in 65% and anti-SGPG antibodies in 82.5% of patients. Anti-MAG antibodies were associated with only demyelinating polyneuropathies. Anti-SGPG antibodies were found in 91% of demyelinating polyneuropathies and 50% of axonopathies. In addition, anti-MAG/SGPG antibody activity was significantly correlated with the subgroup of sensory neuropathies (P < 0.01). Last, antisulfatide antibodies were found at significant titers in 18 cases, and their presence was significantly correlated with anti-MAG/SGPG antibody activity, but not with some clinical/electrophysiological features.
Chassande
B
B
Department of Neurology, Hôpital de la Salpêtrière, Paris, France.
Léger
J M
JM
Younes-Chennoufi
A B
AB
Bengoufa
D
D
Maisonobe
T
T
Bouche
P
P
Baumann
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001323:Autoantibodies / Q000097:blood*; D001369:Axons / Q000502:physiology; D064211:Connectin; D018450:Disease Progression; D004576:Electromyography; D004594:Electrophysiology / Q000379:methods; D005260:Female; D006801:Humans; D007075:Immunoglobulin M; D008297:Male; D008875:Middle Aged; D009124:Muscle Proteins; D018992:Myelin-Associated Glycoprotein / Q000276:immunology; D009194:Myeloma Proteins / Q000276:immunology*; D009431:Neural Conduction; D010265:Paraproteinemias / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D010292:Paresthesia / Q000209:etiology / Q000503:physiopathology; D018579:Patient Selection; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000276:immunology / Q000503:physiopathology*; D012008:Recurrence; D012189:Retrospective Studies
D001323:Autoantibodies; D064211:Connectin; D007075:Immunoglobulin M; D009124:Muscle Proteins; D018992:Myelin-Associated Glycoprotein; D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins