title: Characterizing neuropathies associated with monoclonal gammopathy of undetermined significance (MGUS): a framework consistent with classifying injuries according to fiber size.
abstract: Neuropathies associated with monoclonal gammopathy of undetermined significance (MGUS) occur frequently in the elderly. Data from 42 consecutive elderly patients with a MGUS-associated neuropathy - 12 patients with IgM MGUS, 25 patients with IgG MGUS, 5 patients with IgA MGUS - were evaluated prospectively using quantifiable clinical criteria and quantitative sensory testing. Results consistent with preferential injury to large fibers were found in patients with IgM isotypes (P <.005) but not in patients with IgG isotypes (P <.0005 to.0004). These findings support an immunologic origin for at least some MGUS-associated neuropathies and provide information important for the clinical evaluation of neuropathies in the elderly.
authors.affiliation: Hines Veterans Affairs Hospital, Hines, Illinois, USA. morris.fisher@med.va.gov
authors.forename: Morris A
authors.initials: MA
authors.lastname: Fisher
authors.forename: John R
authors.initials: JR
authors.lastname: Wilson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003937:Diagnosis, Differential; D004568:Electrodiagnosis; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008875:Middle Aged; D009046:Motor Neurons / Q000473:pathology; D009412:Nerve Fibers / Q000473:pathology*; D009460:Neurologic Examination; D009475:Neurons, Afferent / Q000473:pathology; D010265:Paraproteinemias / Q000097:blood / Q000150:complications; D010812:Physical Stimulation; D011115:Polyneuropathies / Q000145:classification* / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D011446:Prospective Studies; D013497:Sural Nerve / Q000473:pathology; D014732:Vibration
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M