Anti-myelin-associated glycoprotein antibodies predict the development of neuropathy in asymptomatic patients with IgM monoclonal gammopathy.
We examined 52 asymptomatic patients with IgM monoclonal gammopathy and correlated anti-myelin-associated glycoprotein (anti-MAG) IgM with the presence of subclinical neuropathy and, in 24 of these patients, with the development of symptomatic neuropathy during a follow-up interval of 40 to 144 months (mean, 75.3 months). Three of 6 patients (50%) with high (>1/6,400) anti-MAG IgM had subclinical neuropathy at entry compared with 2 of 46 patients (4.3%) with low or no reactivity. At follow-up, a symptomatic neuropathy occurred in 3 of 4 patients with high reactivity and in 3 of 21 patients with low or no reactivity. The correlation of high anti-MAG IgM with the presence of subclinical neuropathy or the development of symptomatic neuropathy supports its pathogenetic role in the neuropathy.
Giorgio Spagnol Service of Clinical Neuroimmunology, IRCCS Ospedale Maggiore Policlinico, Milan University, Italy.
N
N
Meucci
L
L
Baldini
A
A
Cappellari
A
A
Di Troia
S
S
Allaria
G
G
Scarlato
E
E
Nobile-Orazio
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007075:Immunoglobulin M; D008297:Male; D008875:Middle Aged; D018992:Myelin-Associated Glycoprotein / Q000276:immunology*; D009422:Nervous System Diseases / Q000276:immunology* / Q000503:physiopathology*; D010265:Paraproteinemias / Q000276:immunology* / Q000503:physiopathology*
D007075:Immunoglobulin M; D018992:Myelin-Associated Glycoprotein