Case of mononeuritis multiplex onset with rituximab therapy for Waldenström's macroglobulinemia.
Waldenström's macroglobulinemia (WM) is a lymphoplasmacytic disorder with associated monoclonal gammopathy. A wide variety of neuropathies can be associated with WM, but most commonly it is a mild length-dependent sensory neuropathy of unclear etiology. Rituximab is a monoclonal antibody which suppresses mature B-cell populations. It has increasingly been used in wide applications including WM, especially in those cases with severe neuropathy. The highlighted case provides an example of rituximab treatment complication in a WM patient with mild sensory neuropathy that evolved to multiple mononeuropathies with features of systemic vasculitis and unusual conversion of type I to type II cryoglobulinemia.
Mauermann
Michelle L
ML
Department of Neurology, Section of Peripheral Nerve, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN 55905, United States.
Ryan
Matthew L
ML
Moon
Joon-Shik
JS
Klein
Christopher J
CJ
D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived; D003449:Cryoglobulinemia / Q000139:chemically induced / Q000276:immunology / Q000503:physiopathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D020422:Mononeuropathies / Q000139:chemically induced* / Q000276:immunology* / Q000503:physiopathology; D010525:Peripheral Nerves / Q000187:drug effects* / Q000276:immunology* / Q000473:pathology; D000069283:Rituximab; D013497:Sural Nerve / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D016896:Treatment Outcome; D014657:Vasculitis / Q000139:chemically induced / Q000276:immunology / Q000503:physiopathology; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy* / Q000276:immunology
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab; D003520:Cyclophosphamide; D008775:Methylprednisolone