Subacute demyelinating polyneuropathy in B-cell lymphoma with IgM antibodies against glycolipid GD1b.
Peripheral neuropathy associated with IgM monoclonal gammopathy of unknown significance is a common disorder, while the association of paraproteinaemic neuropathies with haematological malignancies is far less frequent. We report a 76-year-old patient with a subacute and rapidly progressive sensorimotor demyelinating polyneuropathy causing sensory ataxia, painful paraesthesias and marked motor and sensory deficit in four limbs. Monoclonal gammopathy of IgM type associated with a rectal low-grade B-cell non-Hodgkin lymphoma was detected. Research for anti-MAG and antiganglioside autoantibodies including anti-GM1 and anti-GQ1b evidenced a high titre of IgM antibodies against the disialosyl group of GD1b. This is the first report on a paraproteinaemic polyneuropathy with IgM autoantibodies against glycolipid GD1b associated with B-cell lymphoma. The IgM type of these autoantibodies suggests that they represent all or part of the paraprotein produced by lymphoma cells.
Marfia
G A
GA
Clinica Neurologica, Dipartimento di Neuroscienze, Università di Roma Tor Vergata, Via Oxford 81, I-00133 Rome, Italy. girolama.marfia@uniroma2.it
Pachatz
C
C
Terracciano
C
C
Leone
G
G
Bernardini
S
S
Bernardi
G
G
Massa
R
R
D000368:Aged; D003711:Demyelinating Diseases / Q000209:etiology / Q000276:immunology*; D005260:Female; D005732:Gangliosides / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D016393:Lymphoma, B-Cell / Q000150:complications*; D011115:Polyneuropathies / Q000209:etiology / Q000276:immunology*
D005732:Gangliosides; D007075:Immunoglobulin M; C033851:ganglioside, GD1b