Neurol. praxi. 2016;17(1):28-33 | DOI: 10.36290/neu.2016.006

Paraproteinaemic neuropathies

MUDr. Monika Turčanová Kopruąáková, PhD., prof. MUDr. Egon Kurča, PhD.
Neurologická klinika Jesseniovej LF UK a UN, Martin

There is a wide range of different types of neuropathies that are associated with abnormal immunoglobulin production. They are referred to as paraproteinaemic or dysproteinaemic neuropathies. Paraproteinaemia is a heterogeneous disease in which monoclonal gammopathy can essentially represent a benign process referred to as monoclonal gammopathy of undetermined significance (MGUS). On the other hand, monoclonal gammopathy can point out to the presence of a systemic haematological malignancy. The main diagnoses often linked with peripheral neuropathy include: Waldenström's macroglobulinaemia (WM), POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes), multiple myeloma (MM), and primary amyloidosis (AL). The article presents pathophysiological, clinical, electrophysiological, and therapeutic characteristics of neuropathic syndromes associated with the presence of paraprotein.

Keywords: monoclonal gammopathy, paraprotein, neuropathy, POEMS, myeloma, amyloid

Published: February 1, 2016  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Turčanová Kopruąáková M, Kurča E. Paraproteinaemic neuropathies. Neurol. praxi. 2016;17(1):28-33. doi: 10.36290/neu.2016.006.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Ambler Z. Periférní neruopatie u malignit. Neurol. prax 2013; 14(5): 253-257. Go to original source...
    2. Anderson KC, Alsina M, Bensinger W, Biermann JS, Cohen AD, Devine S, Djulbegovic B, Faber EA Jr, Gasparetto C, Hernandez-Ilizaliturri F, Huff CA, Kassim A, Krishnan AY, Medeiros BC, Meredith R, Raje N, Schriber J, Singhal S, Somlo G, Stockerl-Goldstein K, Treon SP, Tricot G, Weber DM, Yahalom J, Yunus F, Kumar R, Shead DA.Network). NCCN (National Comprehensive Cancer Network). Waldenström's macroglobulinemia/lymphoplasmacytic lymphoma, version 2. J Natl Compr Canc Netw 2012; 10(10): 1211-1219. Go to original source... Go to PubMed...
    3. Capasso M, Torrieri F, Di Muzio A, De Angelis MV, Lugaresi A, Uncini A. Can electrophysiology differentiate polyneuropathy with anti-MAG/SGPG antibodies from chronic inflammatory demyelinating polyneuropathy? Clin Neurophysiol 2002; 113(3): 346-353. Go to original source... Go to PubMed...
    4. Caudie C, Vial C, Petiot P, Bancel J, Lombard C, Gonnaud PM. Monoclonal IgM autoantibody activity vis-?-vis glycoconjugates of peripheral nerves: apropos of 112 cases. Ann Biol Clin (Paris) 2001; 59(5): 567-577.
    5. Cordes S, Dispenzieri A, Lacy MQ, Hayman SR, Buadi FK, Dingli D, Kumar SK, Hogan WJ, Gertz MA. Ten-year survival after autologous stem cell transplantation for immunoglobulin light chain amyloidosis. Cancer 2012; 118(24): 6105-6109. Go to original source... Go to PubMed...
    6. Dalakas MC. Clinical trials in CIDP and chronic autoimmune demyelinating polyneuropathies. J Peripher Nerv Syst 2012; 17(Suppl 2): 34-39. Go to original source... Go to PubMed...
    7. Dalakas MC. Pathophysiology of autoimmune polyneuropathies. Presse Med 2013; 42(6 Pt 2): e181-192. Go to original source... Go to PubMed...
    8. Desport E, Bridoux F, Sirac C, Delbes S, Bender S, Fernandez B, Quellard N, Lacombe C, Goujon JM, Lavergne D, Abraham J, Touchard G, Fermand JP, Jaccard A. Centre national de référence pour l'amylose AL et les autres maladies par dépôts d'immunoglobulines monoclonales. Al amyloidosis. Orphanet J Rare Dis 2012; 7: 54. Go to original source... Go to PubMed...
    9. El-Difrawy MM, Zaki NE, Marouf HM, Ayad MW, Farag AM. Clinical, electrophysiological and immunological study of peripheral nerves in Egyptian patients with monoclonal gammopathies. Int J Hematol 2012; 95(1): 71-76. Go to original source... Go to PubMed...
    10. Ellie E, Vital A, Steck A, Boiron JM, Vital C, Julien J. Neuropathy associated with "benign" anti-myelin-associated glycoprotein IgM gammopathy: clinical, immunological, neurophysiological pathological findings and response to treatment in 33 cases. J Neurol 1996; 243(1): 34-43. Go to original source... Go to PubMed...
    11. Filosto M, Cotelli M, Todeschini A, Broglio L, Vielmi V, Rinaldi F, GregorelliV, Benelle M, Padovani A. Clinical spectrum and evolution of monoclonal gammopathy-associated neuropathy: an observational study. Neurologist 2012; 18(6): 378-384. Go to original source... Go to PubMed...
    12. Graus F, Dalmau J. Paraneoplastic neuropathies. Curr Opin Neurol 2013; 26(5): 489-495. Go to original source... Go to PubMed...
    13. Hadden RD, Nobile-Orazio E, Sommer C. Paraproteinaemic demyelinating neuropathies. In: Gilhus NE, Barnes MP, Brainin M, editor(s). European handbook of neurological management. 2nd ed. Vol. 1. Oxford (UK): Wiley-Blackwell; 2011: 351-361. Go to original source...
    14. Kissel JT, Mendell JR. Neuropathies associated with monoclonal gammopathies. Neuromuscul Disord 1996;6(1):3-18. Go to original source... Go to PubMed...
    15. Kyle RA, Rajkumar SV. Monoclonal gammopathies of undetermined significance: a review. Immunol Rev 2003; 194: 112-139. Go to original source... Go to PubMed...
    16. Kyle RA, Rajkumar SV. Monoclonal gammopathy of undetermined significance. Br J Haematol 2006; 134(6): 573-589. Go to original source... Go to PubMed...
    17. Léger JM, Viala K, Nicolas, Créange A, Vallat JM, Pouget J, Clavelou P, Vial C, Steck A, Musset L, Marin B. RIMAG Study Group (France and Switzerland). Placebo-controlled trial of rituximab in IgM anti-myelin-associated glycoprotein neuropathy. Neurology 2013; 80(24): 2217-2225. Go to original source... Go to PubMed...
    18. Levine T, Pestronk A, Florence J, Al-Lozi MT, Lopate G, Miller T, Rammeantu I, Waheed W, Stambuk M, Stone MJ, Choksi R. Peripheral neuropathies in Waldenström's macroglobulinaemia. J Neurol Neurosurg Psychiatry 2006; 77(2): 224-228. Go to original source... Go to PubMed...
    19. Lunn MP, Nobile-Orazio E. Immunotherapy for IgM anti-myelin-associated glycoprotein paraprotein-associated peripheral neuropathies. Cochrane Database Syst Rev 2012. Go to original source... Go to PubMed...
    20. Min JH, Hong YH, Lee KW. Electrophysiological features of patients with POEMS syndrome. Clin Neurophysiol 2005; 116(4): 965-968. Go to original source... Go to PubMed...
    21. Montoto S, Rozman M, Rosi?ol L, Nadal E, Giné E, Aymerich M, Ferrer A, Esteve J, Bosch F, López-Guillermo A, Bladé J, Monteserrat E. Malignant transformation in IgM monoclonal gammopathy of undetermined significance. Semin Oncol 2003; 30(2): 178-181. Go to original source... Go to PubMed...
    22. Nobile-Orazio E, Meucci N, Baldini L, Di Troja A, Scarlato G. Long-term prognosis of neuropathy associated with anti-MAG IgM M-proteins and its relationship to immune therapies. Brain 2000; 123 (Pt 4): 710-717. Go to original source... Go to PubMed...
    23. Nobile-Orazio E, Casellato C, Di Troia A. Neuropathies associated with IgG and IgA monoclonal gammopathy. Rev Neurol (Paris) 2002; 158(10 Pt 1): 979-987. Go to PubMed...
    24. Nobile-Orazio E, Gallia F, Terenghi F, Allaria S, Giannotta C, Carpo M. How useful are anti-neural IgM antibodies in the diagnosis of chronic immune-mediated neuropathies? J Neurol Sci 2008; 266(1-2): 156-163. Go to original source... Go to PubMed...
    25. Notermans NC, Franssen H, Eurelings M, Van der Graaf Y, Wokke JH. Diagnostic criteria for demyelinating polyneuropathy associated with monoclonal gammopathy. Muscle Nerve 2000; 23(1): 73-79. Go to original source...
    26. Radziwill AJ, Steck AJ, Renaud S, Fuhr P. Distal motor latency and residual latency as sensitive markers of anti-MAG polyneuropathy. J Neurol 2003; 250(8): 962-966. Go to original source... Go to PubMed...
    27. Raheja D, Specht C, Simmons Z. Paraproteinemic neuropathies. Muscle Nerve 2015; 51(1): 1-13. Go to original source... Go to PubMed...
    28. Rajabally YA. Neuropathy and paraproteins: review of a complex association. Eur J Neurol 2011; 18(11): 1291-1298. Go to original source... Go to PubMed...
    29. Richardson PG, Delforge M, Beksac M. Management of treatment-emergent peripheral neuropathy in multiple myeloma. Leukemia 2012; 26(4): 595-608. Go to original source... Go to PubMed...
    30. Ritz MF, Erne B, Ferracin F, Vital C, Steck AJ. Anti-MAG IgM penetration into myelinated fibers correlates with the extent of myelin widening. Muscle Nerve 1999; 22(8): 1030-1037. Go to original source...
    31. Rojas-García R, Gallardo E, de Andrés I, de Luna N, Juarez C, Sánchez P, Illa I. Chronic neuropathy with IgM anti-ganglioside antibodies: lack of long term response to rituximab. Neurology 2003; 61(12): 1814-1816. Go to original source... Go to PubMed...
    32. Rojas-García R, Gallardo E, Illa I. Paraproteinemic neuropathies. Presse Med 2013; 42(6 Pt 2): e225-234. Go to original source... Go to PubMed...
    33. Zivkovic SA, Lacomis D, Lentzsch S. Paraproteinemic neuropathy. Leuk Lymphoma. 2009; 50(9): 1422-1433. Go to original source... Go to PubMed...

    Return to the content


    Neurology for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.