Main Article
Long-term clinical and neurophysiological follow-up of patients with peripheral, neuropathy associated with benign monoclonal gammopathy†
Sawanthana Ponsford BSc, FRCP,
Hugh Willison PhD, FRCP,
Jean Veitch,
Richard Morris PhD,
P.K. Thomas DSc, FRCP,
Corresponding Author
Sawanthana Ponsford BSc, FRCP
Department of Clinical Neurophysiology, Walsgrave Hospital, Clifford Bridge Road, Coventry, CV2 2DX, UK
Department of Clinical Neurophysiology, Walsgrave Hospital, Clifford Bridge Road, Coventry, CV2 2DX, UKSearch for more papers by this authorHugh Willison PhD, FRCP
Department of Neurology, Southern General Hospital, Glasgow, UK
Search for more papers by this authorJean Veitch
Department of Neurology, Southern General Hospital, Glasgow, UK
Search for more papers by this authorRichard Morris PhD
Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK
Search for more papers by this authorP.K. Thomas DSc, FRCP
Department of Clinical Neurology, Institute of Neurology, London, UK
Department of Clinical Neurosciences, Royal Free and University College Medical School, London, UK
Search for more papers by this authorSawanthana Ponsford BSc, FRCP,
Hugh Willison PhD, FRCP,
Jean Veitch,
Richard Morris PhD,
P.K. Thomas DSc, FRCP,
Corresponding Author
Sawanthana Ponsford BSc, FRCP
Department of Clinical Neurophysiology, Walsgrave Hospital, Clifford Bridge Road, Coventry, CV2 2DX, UK
Department of Clinical Neurophysiology, Walsgrave Hospital, Clifford Bridge Road, Coventry, CV2 2DX, UKSearch for more papers by this authorHugh Willison PhD, FRCP
Department of Neurology, Southern General Hospital, Glasgow, UK
Search for more papers by this authorJean Veitch
Department of Neurology, Southern General Hospital, Glasgow, UK
Search for more papers by this authorRichard Morris PhD
Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK
Search for more papers by this authorP.K. Thomas DSc, FRCP
Department of Clinical Neurology, Institute of Neurology, London, UK
Department of Clinical Neurosciences, Royal Free and University College Medical School, London, UK
Search for more papers by this authorFirst published: 18 January 2000
Citations: 44
†
Presented in part at the XI International Congress of EMG and Clinical Neurophysiology, Prague, September 1999.
Abstract
The incidence of hematological malignancy in patients with monoclonal gammopathy of undetermined significance (MGUS) has been assessed as 17% to 25%. To ascertain whether this is true of neuropathy associated with MGUS, a long-term (5–42 years) retrospective clinical and neurophysiological follow-up was conducted in 50 cases (immunoglobulin M [IgM], n = 38; IgG, n = 11; IgA, n = 1). Only three patients developed hematological malignancy. Of 25 survivors with IgM paraproteinemia, 7 had myelin-associated glycoprotein antibodies with typical clinical features. Evoked distal muscle amplitudes were significantly smaller than for the other paraprotein classes. Preferential distal demyelination manifested by relative prolongation of distal motor latency was not apparent in the cases of long duration. Two patients with IgM antidisialosyl antibodies and cold agglutinating activity had a large fiber neuropathy with intermittent oculofacial involvement. Both responded to intravenous immunoglobulin. Findings in the remaining patients were varied. Recognition of IgM subgroups is important both for prognosis and possible response to treatment. © 2000 John Wiley & Sons, Inc. Muscle Nerve 23: 164–174, 2000.
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