title: Clinical and laboratory features of neuropathies with serum IgM binding to TS-HDS.
abstract: BACKGROUND
  In this investigation we studied clinical and laboratory features of polyneuropathies in patients with serum IgM binding to the trisulfated disaccharide IdoA2S-GlcNS-6S (TS-HDS).
  
  
  METHODS
  We retrospectively compared 58 patients with selective IgM binding to TS-HDS to 41 consecutive patients with polyneuropathies without TS-HDS binding.
  
  
  RESULTS
  Patients with IgM vs. TS-HDS commonly had distal, sensory, axonal neuropathies. Weakness was associated with IgM M-proteins. Hand pain and serum IgM M-proteins were more common than in control neuropathy patients. TS-HDS antibody binding was often selectively κ class. Biopsies showed capillary pathology with thickened basal lamina and C5b9 complement deposition. IgM in sera with TS-HDS antibodies often bound to capillaries.
  
  
  CONCLUSIONS
  Serum IgM binding to TS-HDS is associated with painful, sensory > motor, polyneuropathies with an increased frequency of persistent hand discomfort, serum IgM M-proteins, and capillary pathology. Serum IgM binding to TS-HDS suggests a possible immune etiology underlying some otherwise idiopathic sensory polyneuropathies.
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, Missouri 63110, USA. pestronka@neuro.wustl.edu
authors.forename: Alan
authors.initials: A
authors.lastname: Pestronk
authors.forename: Robert E
authors.initials: RE
authors.lastname: Schmidt
authors.forename: Rati M
authors.initials: RM
authors.lastname: Choksi
authors.forename: R Brian
authors.initials: RB
authors.lastname: Sommerville
authors.forename: Muhammad T
authors.initials: MT
authors.lastname: Al-Lozi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002196:Capillaries / Q000473:pathology; D064211:Connectin; D004187:Disaccharides / Q000378:metabolism*; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009124:Muscle Proteins / Q000097:blood*; D018482:Muscle, Skeletal / Q000473:pathology; D010146:Pain / Q000453:epidemiology; D011115:Polyneuropathies / Q000097:blood* / Q000276:immunology / Q000473:pathology*; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D064211:Connectin; D004187:Disaccharides; D007075:Immunoglobulin M; D009124:Muscle Proteins