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Paraneoplastic Demyelinating Neuropathy, a Multifactorial Disease and Approach to Management.

Abigael Luke, James Vredenburgh

Connecticut Medicine

|June 14, 2018

Summary

A paraneoplastic syndrome caused severe neuropathy in a patient with lymphoplasmacytic lymphoma. Treatment targeting both the malignancy and immune attack led to significant recovery.

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Area of Science:

Neurology
Oncology
Immunology

Background:

Paraneoplastic syndromes can manifest as immune-mediated neurological disorders.
Lymphoplasmacytic lymphoma is a B-cell malignancy associated with plasma cell dyscrasia.

Observation:

A 53-year-old male presented with demyelinating polyneuropathy, a potential paraneoplastic complication.
The patient experienced severe neurological deficits, including near quadriplegia, necessitating mechanical ventilation.

Findings:

The patient's condition was linked to an immune-mediated event stemming from lymphoplasmacytic lymphoma.
Combined systemic therapy for the malignancy and immunomodulatory treatment resulted in substantial neurological recovery.

Implications:

Effective management requires addressing both the underlying plasma cell dyscrasia and the specific immune targets.
Targeting peripheral antibodies is crucial for preventing further nervous system damage in similar cases.