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Canomad presenting without ophthalmoplegia and responding to intravenous immunoglobulin
Cheryl Kam1, Michelle S Balaratnam, Alistair Purves
1Portsmouth Hospital NHS Trust, Portsmouth, UK.
Abstract:
The acronym CANOMAD encompasses chronic ataxic neuropathy combined with ophthalmoplegia, M protein, cold agglutinins, and anti-disialosyl antibodies.Herein we describe 2 patients presenting with progressive ataxic neuropathy who only developed ophthalmoplegia after a significant delay post-presentation, which in 1 case had features indicative of brainstem dysfunction. Both patients were found to have an IgM paraprotein and anti-disialosyl antibodies. They responded to treatment with intravenous immunoglobulin, thus illustrating the importance of diagnosing this condition.
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