Waldenstrom's Macroglobulinaemia Presenting as Demyelinating Polyradiculoneuropathy

Area of Science:

• Neurology
• Hematology
• Oncology

Background:

• Peripheral neuropathy is a common neurological disorder, particularly in the elderly.
• Monoclonal gammopathies, including Waldenstrom's Macroglobulinaemia (WM), can be associated with peripheral neuropathy.
• The neurological symptoms may precede the hematological diagnosis of WM by several years.

Observation:

• A case of subacute demyelinating peripheral neuropathy was observed.
• This neuropathy was associated with Waldenstrom's Macroglobulinaemia.
• The patient presented with neurological symptoms prior to the hematological diagnosis.

Findings:

• Prompt resolution of peripheral neuropathy occurred following intravenous immunoglobulin therapy.
• Subsequent treatment with cyclophosphamide and plasmapheresis led to complete clinical remission.
• No further neurological relapses were observed after treatment.

Implications:

• Highlights the importance of screening for monoclonal proteins in elderly patients with unexplained peripheral neuropathy.
• Suggests that early detection and treatment of WM-associated neuropathy can lead to favorable outcomes.
• Demonstrates the efficacy of a multi-modal treatment approach including immunotherapy and chemotherapy for WM-related neurological complications.