Neurologic Disorders in Benign and Malignant Plasma Cell Dyscrasias

Kelly, John J.

doi:10.1007/978-1-59259-317-0_26

Cancer Neurology in Clinical Practice 2003

DOI: 10.1007/978-1-59259-317-0_26

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Neurologic Disorders in Benign and Malignant Plasma Cell Dyscrasias

John J. Kelly¹

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2008

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“…Monoclonal gammopathies (paraproteins or monoclonal proteins) are produced by proliferating clones of plasma cells of different immunoglobulin type (IgM, IgG, IgA). Primary amyloidosis may cause neurologic complications when light chains of these proteins coalesce forming beta‐pleated sheets of amyloid in nerves 3, 7, 12. Patients with primary amyloidosis have a poor prognosis with shortened life expectancy.…”

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Antibodies to myelin‐associated glycoprotein (anti‐Mag) in IgM amyloidosis may influence expression of neuropathy in rare patients

et al. 2008

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We have examined whether antibodies to myelin-associated glycoprotein (anti-MAG) influence neuropathy occurrence and phenotype in primary (AL IgM) amyloidosis. Anti-MAG and the cross-reacted sulfoglucuronyl paragloboside antibodies (SGPG) were studied in 46 patients with IgM amyloidosis (21 with polyneuropathy), and 21 matched IgM MGUS (monoclonal gammopathies of undetermined significance) controls without neuropathy. We assessed the occurrence, phenotype of neuropathy, and attributes of nerve conduction and their relation to antibody activity. Twenty of 46 patients with IgM amyloidosis (7 with and 13 without polyneuropathy) had elevation of anti-MAG or SGPG by enzyme-linked immunosorbent assay (ELISA). Two of the polyneuropathy patients with IgM amyloidosis had antibodies to MAG based on Western blot (WB) positivity. One of these patients, with the highest anti-MAG titer, had a painful sensory ataxia, with prominent demyelination, and amyloid deposition in sural nerve. The other anti-MAG WB-positive amyloid patient had an axonal neuropathy and dysautonomia. Low levels of anti-MAG antibodies were found in 12 of 21 IgM MGUS controls without neuropathy (mean follow-up, 11 years). We conclude that finding serum anti-MAG antibodies does not exclude the diagnosis of primary amyloidosis. They do not appear to affect the occurrence or expression of polyneuropathy, except possibly in occasional cases with WB positivity.

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Antibodies to myelin‐associated glycoprotein (anti‐Mag) in IgM amyloidosis may influence expression of neuropathy in rare patients

et al. 2008

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Neurologic Disorders in Benign and Malignant Plasma Cell Dyscrasias

Cited by 1 publication

References 59 publications

Antibodies to myelin‐associated glycoprotein (anti‐Mag) in IgM amyloidosis may influence expression of neuropathy in rare patients

Antibodies to myelin‐associated glycoprotein (anti‐Mag) in IgM amyloidosis may influence expression of neuropathy in rare patients

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