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Mental nerve neuropathy: a symptom of Waldenström's macroglobulinemia
P R Klokkevold1, D A Miller, A H Friedlander
1Section of Hospital Dentistry, University of California at Los Angeles, School of Dentistry and Medical Center.
Abstract:
The uncontrolled production of immunoglobulins in Waldenström's macroglobulinemia, a neoplastic plasma cell disorder, results in hyperviscosity of blood and multisystem organ derangement. Previously reported orofacial manifestations have been limited to osteolytic lesions of the jaw, ulcerations of the mucosa and tongue, gingival bleeding, and enlargement of salivary and lacrimal glands. Mental nerve anesthesia resulting from IgM deposition on the myelin sheath is a previously unreported early warning sign of advancing disease. Its occurrence heralds the need for aggressive medical management.
Insights
Mental nerve anesthesia is an early indicator of Waldenström's macroglobulinemia progression. This symptom, caused by immunoglobulin M deposition, signals the need for prompt and aggressive treatment of this plasma cell disorder.
Area of Science:
- Hematology
- Oncology
- Neurology
Background:
- Waldenström's macroglobulinemia is a neoplastic plasma cell disorder characterized by uncontrolled immunoglobulin M production.
- This uncontrolled production leads to hyperviscosity and multisystem organ damage.
- Previously documented orofacial manifestations include osteolytic lesions, mucosal ulcerations, bleeding, and gland enlargement.
Observation:
- A novel orofacial manifestation, mental nerve anesthesia, has been identified.
- This anesthesia results from immunoglobulin M deposition on the myelin sheath of the mental nerve.
Findings:
- Mental nerve anesthesia serves as a previously unreported early warning sign of advancing Waldenström's macroglobulinemia.
- The presence of this symptom indicates disease progression.
Implications:
- Early identification of mental nerve anesthesia can prompt timely and aggressive medical management.
- This finding may improve patient outcomes by facilitating earlier intervention in Waldenström's macroglobulinemia.