title: A case of peripheral nerve microvasculitis associated with multiple myeloma and bortezomib treatment.
abstract: BACKGROUND
  Bortezomib-induced peripheral neuropathy typically presents as a painful, length-dependent sensory predominant neuropathy.
  
  
  METHODS
  A case report, including nerve pathology, is presented of a man with multiple myeloma who developed a severe motor predominant polyradiculoneuropathy in the setting of bortezomib treatment. We also review the Mayo Clinic Hematology Dysproteinemia database for patients treated with bortezomib.
  
  
  RESULTS
  A 53-year-old man with Stage III multiple myeloma developed a severe motor predominant polyradiculoneuropathy following bortezomib treatment with electrophysiological features of multiple conduction blocks and pathological evidence of peripheral nerve microvasculitis. Our institutional experience is that 36.5% of dysproteinemia patients treated with bortezomib develop treatment-emergent peripheral neuropathy, and the most common pattern is a painful sensory predominant peripheral neuropathy.
  
  
  CONCLUSIONS
  A motor predominant polyradiculoneuropathy is a rare presentation of bortezomib-associated peripheral neuropathy in multiple myeloma patients which may progress despite treatment withdrawal and may be due to microvasculitis.
authors.affiliation: Department of Neurology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, Minnesota 55905, USA. mauermann.michelle@mayo.edu
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Mauermann
authors.forename: Martin S
authors.initials: MS
authors.lastname: Blumenreich
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: Nathan P
authors.initials: NP
authors.lastname: Staff
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D009431:Neural Conduction; D010525:Peripheral Nerves / Q000187:drug effects / Q000503:physiopathology; D011719:Pyrazines / Q000627:therapeutic use*; D056647:Systemic Vasculitis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib