Lymphocytes in sural nerve biopsies from patients with plasma cell dyscrasia and polyneuropathy.
Sural nerve biopsies were examined in 36 patients with plasmacell dyscrasia and polyneuropathy. The M-component isotype was IgM in 19, IgG in 16 (one patient had both IgM and IgG) and IgA in 2 patients. Five of the IgM patients had Waldenström's disease, one of the IgG cases a myeloma and two lymphoma. The remaining 28 patients had monoclonal gammopathy of uncertain significance (MGUS). Nerve conduction studies showed signs of mixed axonal/demyelinating polyneuropathy in most cases. The biopsies were evaluated with regard to nerve fibre loss, segmental demyelination and inflammatory cell infiltration. Inflammatory cells infiltrating the nerves were found in 7 of 19 IgM cases and in 6 of 16 IgG cases. Immunohistochemical staining with monoclonal antibodies to B-lymphocytes and to subsets of T-lymphocytes was performed in 33 cases. An equal distribution of CD4 and CD8 positive T cells, but no B cells, were found among the inflammatory cells. The findings indicate a possible role for cell mediated immunological mechanisms in some patients with plasma cell dyscrasia associated with polyneuropathy.
Solders
G
G
Department of Neurology, Huddinge Hospital, Sweden. goran.solders@neuro.hs.sll.se
Nennesmo
I
I
Ernerudh
J
J
Cruz
M
M
Vrethem
M
M
D000328:Adult; D000368:Aged; D016175:B-Lymphocyte Subsets / Q000276:immunology / Q000473:pathology; D001706:Biopsy; D004576:Electromyography; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008214:Lymphocytes / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D010265:Paraproteinemias / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D013497:Sural Nerve / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000473:pathology; D008258:Waldenstrom Macroglobulinemia / Q000276:immunology / Q000473:pathology
D007074:Immunoglobulin G; D007075:Immunoglobulin M