Peripheral neuropathy associated with monoclonal IgG of undetermined significance: clinical, electrophysiologic, pathologic and therapeutic study of 14 cases.
Fourteen patients with peripheral neuropathy and monoclonal IgG of undetermined significance are reported with a retrospective study of the clinical features, electrophysiologic and sural nerve biopsy findings. There were two groups. Five patients had a relapsing chronic sensorimotor polyneuropathy with clinical (5/5), electrophysiologic (4/5) and pathologic (5/5) features compatible with chronic inflammatory demyelinating polyneuropathies (CIDP). The nine others had a slowly progressive sensory (5/9) (SPNP) or sensorimotor (4/9) (SMPNP) axonal polyneuropathy. Four patients of the first group were treated with intravenous human immunoglobulin (400 mg/kg/day for five days) with significant clinical improvement. The motor conduction velocities and distal latencies of two of these patients improved following treatment, thus matching the clinical improvement. Our results on peripheral nerve biopsies confirm the differentiation of patients with CIDP from those with SMPNP and SPNP. There was no specific immunologic serologic reactivity in any of the cases.
Hermosilla
E
E
Department of Neurology, Bordeaux II University, France.
Lagueny
A
A
Vital
C
C
Vital
A
A
Ferrer
X
X
Steck
A
A
Julien
J
J
D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000097:blood*; D001706:Biopsy; D004576:Electromyography; D005260:Female; D015417:Hereditary Sensory and Motor Neuropathy / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology; D006644:Histiocytes / Q000473:pathology / Q000648:ultrastructure; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology / Q000648:ultrastructure; D009431:Neural Conduction; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology; D012189:Retrospective Studies
D000911:Antibodies, Monoclonal; D007074:Immunoglobulin G