Neuropathology of paraneoplastic neuropathy with anti-disialosyl antibody.
We report a paraneoplastic neuropathy with severe motor involvement following sensory-ataxic disturbance. Anti-disialosyl immunoglobulin M (IgM) antibody was detected in the course of malignant lymphoma of diffuse large B-cell type, which usually spares the motor system. Onset was subacute, with relapsing and remitting sensory ataxia, muscle weakness, bulbar palsy, respiratory paralysis, and ophthalmoplegia; only neck rotation was retained in the terminal stage. Autopsy showed no lymphoma cells infiltrating the nervous system. Motor neurons survived in the spinal cord, but mean diameter of the ventral spinal nerve roots was reduced considerably. The gracile fasciculus and the sural nerve were more markedly degenerated than proximal portions. Morphometric study showed that most of the proximal motor and sensory axons did not extend distally. This autopsy report provides further definition of a neuropathy associated with malignant lymphoma and IgM antibodies against disialosyl residues.
Kobayashi
Michio
M
Department of Internal Medicine, Akita University School of Medicine, 1-1-1, Hondo, Akita 010-8543, Japan.
Kato
Kazumaro
K
Funakoshi
Kei
K
Watanabe
Sumio
S
Toyoshima
Itaru
I
D000368:Aged; D001259:Ataxia / Q000473:pathology / Q000503:physiopathology; D001323:Autoantibodies / Q000276:immunology*; D002490:Central Nervous System / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D020278:Demyelinating Autoimmune Diseases, CNS / Q000209:etiology / Q000276:immunology / Q000503:physiopathology; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D017809:Fatal Outcome; D005732:Gangliosides / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000276:immunology; D008297:Male; D018908:Muscle Weakness / Q000473:pathology / Q000503:physiopathology; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009434:Neural Pathways / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D020364:Paraneoplastic Polyneuropathy / Q000276:immunology* / Q000473:pathology* / Q000503:physiopathology; D010525:Peripheral Nerves / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology
D001323:Autoantibodies; D005732:Gangliosides; D007075:Immunoglobulin M; C025447:sialogangliosides