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[Neuropathies and monoclonal dysglobulinemias]
Annales De Medecine Interne
|January 1, 1986
Summary
Peripheral neuropathy associated with monoclonal gammopathy can present with neurological symptoms and nerve damage. The direct cause of this neuropathy remains unclear, with multiple potential factors under investigation.
Area of Science:
- Neurology
- Immunology
- Pathology
Context:
- Peripheral neuropathy is a complex condition.
- Monoclonal gammopathy is associated with various neurological disorders.
- Understanding the link between monoclonal gammopathy and neuropathy is crucial for diagnosis and treatment.
Purpose:
- To present findings on peripheral neuropathy in patients with monoclonal gammopathy.
- To review existing literature on this association.
- To discuss potential pathogenic mechanisms and diagnostic challenges.
Summary:
- Presents nine cases of peripheral neuropathy with monoclonal gammopathy (multiple myeloma, Waldenström's macroglobulinemia), noting symptoms like tremor, ataxia, delayed nerve conduction, and increased cerebrospinal fluid protein.
- Reviews 185 cases, discussing potential causes including microvascular changes, amyloid deposition, and antibodies (e.g., anti-MAG), though the exact pathogenic role remains unresolved.
- Highlights that neuropathy symptoms can precede paraprotein detection and that nerve damage involves both myelin and axons, with treatment success rates varying.
Impact:
- Provides insights into the clinical presentation and pathological findings of neuropathy in monoclonal gammopathy.
- Contributes to the ongoing discussion regarding the etiology of paraproteinemic neuropathy.
- Emphasizes the need for further research to clarify the relationship between paraproteins and nerve damage.