IgM gammopathy and polyneuropathy react with an antigenic glycolipid present in human central nervous system

An immunological mechanism may be responsible for the peripheral neuropathies associated with the IgM monoclonal gammopathies. Myelin-associated glycoprotein, and sulfated glucuronic acid-glycosphingolipids of the paragloboside type specific of peripheral nervous system (PNS), have been found to be targets for these antibodies. We report here on the presence of a glycolipid antigen present in central nervous system white matter in 7 of 12 patients with IgM monoclonal gammopathy and neuropathy whose IgM reacts also with the specific sulfated glycolipids of PNS. Immunodetection of the antibodies was performed on thin-layer plates after separation of the glycosphingolipids from peripheral nerve and white matter. The lipid antigen had a migration on thin-layer chromatography close to sulfogalactosylceramide but the sulfatide standard did not react with the monoclonal IgM.