Journal article
Peripheral Neuropathy Associated with Monoclonal Gammopathy. Studies of Intraneural Injections of Monoclonal Immunoglobulin Sera
Journal of neuropathology and experimental neurology, Vol.41(4), pp.446-459
07/1982
DOI: 10.1097/00005072-198207000-00007
PMID: 6283037
Abstract
A causal relationship between paraproteinemia and neuropathies has been suggested. We studied three patients with chronic sensorimotor polyneuropathy associated with plasma cell dyscrasia and monoclonal gammopathies (IgGK, IgMK, IgAλ). Sural nerve biopsies showed mild (2 cases) to moderate loss of myelinated fibers (1 case). Teased single fiber studies showed segmental demyelination-remyelination in two patients. Direct immunofluorescence demonstrated immune deposits of the myelin sheath of the same specificity as the serum paraprotein, IgGK (1 of 3 cases). Treatment with prednisone, melphalan or chlorambucil, and plasma-pheresis resulted in remission (1 case), partial improvement (1 case), or had no effect (1 case), although reduction of monoclonal immunoglobulin occurred in all. To investigate the role the paraproteins might play in the pathogenesis of the neuropathy, patientsʼ serum was injected intraneurally into rat sciatic nerves. None of the animals developed weakness, slowing of in vitro conduction of sciatic nerve, or significant evidence of demyelination by light- or electron-microscopy or teased single fiber studies 48 hours postinjection. Similar injections of rabbit serum with experimental allergic neuritis (EAN) produced focal segmental demyelination. Our studies employing an in vivo bioassay technique failed to establish antimyelin activity of monoclonal immunoglobulin sera.
Details
- Title: Subtitle
- Peripheral Neuropathy Associated with Monoclonal Gammopathy. Studies of Intraneural Injections of Monoclonal Immunoglobulin Sera
- Creators
- E BoschLINDA AnsbacherJAMES GoekenPASQUALE Cancilla
- Resource Type
- Journal article
- Publication Details
- Journal of neuropathology and experimental neurology, Vol.41(4), pp.446-459
- DOI
- 10.1097/00005072-198207000-00007
- PMID
- 6283037
- NLM abbreviation
- J Neuropathol Exp Neurol
- ISSN
- 0022-3069
- eISSN
- 1554-6578
- Publisher
- American Association of Neuropathologists, Inc
- Language
- English
- Date published
- 07/1982
- Academic Unit
- Pathology
- Record Identifier
- 9984204115502771
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