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Peripheral neuropathies in Waldenström's macroglobulinaemia
T Levine1, A Pestronk, J Florence
1Phoenix Neurological Associates, AZ, USA.
Journal of Neurology, Neurosurgery, and Psychiatry
|January 20, 2006
Summary
Polyneuropathy is common in Waldenström's macroglobulinaemia (WM), causing sensory loss and gait issues. Specific IgM antibodies (MAG or sulphatide) worsen nerve damage in WM patients.
Area of Science:
- Neurology
- Hematology
- Immunology
Background:
- Waldenström's macroglobulinaemia (WM) is a rare lymphoproliferative disorder characterized by malignant lymphocytes producing monoclonal IgM.
- Peripheral neuropathy is a recognized complication, but its prevalence and specific features in WM require further elucidation.
Purpose of the Study:
- To investigate the prevalence, clinical characteristics, and laboratory findings of polyneuropathies in patients diagnosed with Waldenström's macroglobulinaemia.
- To compare neurological findings in WM patients with a control group.
Main Methods:
- Prospective study of 119 WM patients and 58 controls.
- Comprehensive assessments including medical history, neurological examinations, electrodiagnostic tests, and serum studies.
- Examiners were blinded to WM diagnosis, ensuring objective data collection.
Main Results:
- Polyneuropathy symptoms were significantly more frequent in WM patients (47%) than controls (9%), with prevalent leg discomfort and sensory loss.
- WM patients exhibited reduced vibration scores, increased pinprick sensory loss, and gait disorders compared to controls.
- Specific IgM binding to sulphatide or myelin-associated glycoprotein (MAG) was associated with more severe sensory axon loss and/or demyelination.
Conclusions:
- Peripheral nerve involvement, particularly sensory polyneuropathy and gait disturbances, is common in WM.
- IgM binding to MAG or sulphatide identifies a subset of WM patients with a higher risk of severe neuropathy.
- Age-related nerve function decline contributes to neurological deficits in WM, similar to the general population.
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