title: Acute inflammatory neuropathy with monoclonal anti-GM2 IgM antibodies, IgM-κ paraprotein and additional autoimmune processes in association with a diffuse large B-cell non-Hodgkin's lymphoma.
abstract: Lymphoproliferative disorders are often associated with autoimmune processes preceding or following the occurrence of a lymphoma. Here, we describe a patient with a history of recurrent diffuse large B-cell non-Hodgkin's lymphoma who suffered from an acute inflammatory neuropathy with specific monoclonal anti-GM2 IgM antibodies and associated IgM-κ paraprotein. It was possible in this case to prove that both, anti-GM2 IgM antibodies and IgM-κ paraprotein, share the same binding characteristic. In addition, the patient possibly suffered from an immune thrombocytopenia and an early-stage bullous pemphigoid with anti-BP-230 IgG antibodies. Intravenous immunoglobulin and plasmapheresis alleviated the acute neuropathy and thrombocytopenia, while the bullous pemphigoid has been aggravated. In summary, the simultaneous occurrence of multiple autoimmune processes was a sign of a dysfunctional immune system preceding the relapse of a B-cell non-Hodgkin's lymphoma.
authors: Department of Neurology, University Medical Center Magdeburg A.ö.R, Magdeburg, Germany. annette.milnik@unibas.ch
authors: Annette
authors: A
authors: Milnik
authors: Dirk
authors: D
authors: Roggenbuck
authors: Karsten
authors: K
authors: Conrad
authors: Claudius
authors: C
authors: Bartels
mesh_terms: D000368:Aged; D003389:Cranial Nerve Diseases / Q000150:complications / Q000276:immunology* / Q000628:therapy; D005678:G(M2) Ganglioside / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000188:drug therapy; D008297:Male; D010266:Paraproteins / Q000378:metabolism*; D010391:Pemphigoid, Bullous / Q000150:complications; D010956:Plasmapheresis; D011129:Polyradiculoneuropathy / Q000150:complications / Q000276:immunology* / Q000628:therapy; D012008:Recurrence; D013921:Thrombocytopenia / Q000150:complications
chemical_list: D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D010266:Paraproteins; D005678:G(M2) Ganglioside