IgG neuropathy: an immunoelectron microscopic study.
There are many potential mechanisms of peripheral nerve impairment by a monoclonal IgG dysglobulinemia. In this study, using electron microscopy, we observed widening of the myelin lamellae comparable to that commonly described in IgM neuropathies with antimyelin-associated glycoprotein activity. Such features have yet to be described in IgG neuropathies. In addition, we observed deposits of a granular material in the interstitial tissue of the nerve. By immunoelectron microscopy, we demonstrated the presence of the IgG in the lesions of myelin and the endoneurial space. A direct link between monoclonal dysglobulinemia (regardless of type) and polyneuropathy should be confirmed by nerve biopsy, because the result may influence treatment.
Vallat
Jean-Michel
JM
Department of Neurology, University Hospital, 2 Avenue Martin Luther King, 87042 Limoges, France. vallat@unilim.fr
Magy
Laurent
L
Sindou
Philippe
P
Magdelaine
Corinne
C
Cros
Didier
D
D000888:Antibodies, Anti-Idiotypic / Q000378:metabolism; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D016253:Microscopy, Immunoelectron / Q000379:methods*; D008875:Middle Aged; D009186:Myelin Sheath / Q000276:immunology / Q000648:ultrastructure; D011115:Polyneuropathies / Q000097:blood / Q000276:immunology / Q000473:pathology*
D000888:Antibodies, Anti-Idiotypic; D007074:Immunoglobulin G