Waldenström's macroglobulinemia developing in a patient with multiple sclerosis: coincidence or association?

Abstract

Multiple sclerosis (MS) has been reported in association with haematological abnormalities, including monoclonal gammopathies. We present a 54-year-old male patient with a 30-year history of MS who was admitted to our hospital for investigation of anaemia and increased erythrocyte sedimentation rate. A monoclonal IgM protein was detected by serum protein immunofixation, while bone marrow biopsy indicated a 70% infiltration by small lymphoplasmacytoid cells, in the context of a lymphoplasmacytoid immunocytoma, findings compatible to the diagnosis of Waldenström's macroglobulinemia (WM). To our knowledge, this is the first report of WM in a patient with MS. Further to the coexistence of the two diseases observed in the case presented here, there is additional evidence suggesting that the association of MS with plasma cell dyscrasias may not be coincidental.

Autoimmune manifestations in patients with multiple myeloma and monoclonal gammopathy of undetermined significance

“…One report described MM that developed in a patient suffering from MS for 26 years [76] . Similarly, a case of Waldenstrom's macroglobulinemia was described in a patient suffering from MS for 39 years [77] . Conversely, MS and peripheral demyelinating neuropathies have been described in patients with monoclonal gammopathies [78] .…”

Cancer risk and impact of disease-modifying treatments in patients with multiple sclerosis

“…Previous studies have focused on the possible association between MS and CNS [19][20][21], bladder, breast [6], skin [22], hematological and lymphatic cancers [10,12,23] (Table 5). In the present study, the observed number of brain tumors, hematological, skin, lymphatic and digestive cancers did not exceed the expected number.…”

Autoimmune Manifestations in Patients With Waldenström Macroglobulinemia

“…Whether the coexistence of these neurologic diseases and WM is coincidental or a result of common pathogenetic mechanisms remains to be answered. Several case reports document WM developing in patients with MS. 36,37 Conversely, there are reports of MS that developed in patients with monoclonal gammopathies. 38,39 This association between MS and WM could be explained by a shared genetic susceptibility or, possibly, a common immune abnormality.…”

“…30 Furthermore, deposits of IgM were observed in the endoneurium of the damaged nerve fibers. 31 There are reports of myasthenia gravis, 32-34 amyotrophic lateral sclerosis, 29,35 and multiple sclerosis (MS) 36 in patients with WM. Whether the coexistence of these neurologic diseases and WM is coincidental or a result of common pathogenetic mechanisms remains to be answered.…”