Monoclonal Gammopathy in Patients with Neuropathy
Background:
The incidence of monoclonal gammopathy of undetermined significance (MGUS) in the population of over 50-year-olds is approximately 3% and increases with age. The association between MG and neuropathy has been of interest for several years, but the causal relationship has not yet been clarified.
Methods:
For 682 patients who visited the Department of Neurology and requested tests for MG work-up, we retrospectively collected demographic and clinical information, such as age, gender, diagnosis, and neurologic and laboratory test results, from their medical records.
Results:
Out of a total of 682 patients who were suspected of neuropathy and tested for monoclonal gammopathy (MG), twelve (1.76%) showed MG on their serum protein electrophoresis. The most common form was IgM-κ with five patients, followed by IgG-κ, IgG-λ, and biclonal IgG-λ and IgA-κ. The results of the immunoglobulin quantitation test and free light chain assay showed that involved M-protein values in these patients were increased. Some patients were positive for anti-myelin-associated glycoprotein (MAG) antibody, anti-GD1b IgM antibody, anti-GM1 IgG & IgM antibody, and anti-cardiolipin IgM antibody. Also, some had antinuclear antibody (ANA) or antineutrophil cytoplasmic antibody (ANCA).
Conclusions:
In the future, it is necessary to investigate the pathogenic relationship between M-protein and autoantibodies in patients with neuropathies.
Insights
Monoclonal gammopathy (MG) was found in 1.76% of patients with suspected neuropathy. Further research is needed to clarify the link between M-protein, autoantibodies, and neuropathy.
Area of Science:
- Neurology
- Immunology
- Medical Diagnostics
Background:
- Monoclonal gammopathy of undetermined significance (MGUS) affects about 3% of individuals over 50, with incidence increasing with age.
- A potential link between monoclonal gammopathy (MG) and neuropathy has been observed, but the causal relationship remains unclear.
Purpose of the Study:
- To investigate the prevalence of MG in patients presenting with neuropathy.
- To identify the types of MG and associated autoantibodies in this patient cohort.
Main Methods:
- Retrospective analysis of 682 patients undergoing MG work-up in a neurology department.
- Collection of demographic, clinical, neurological, and laboratory data, including serum protein electrophoresis and immunoglobulin assays.
Main Results:
- Monoclonal gammopathy (MG) was detected in 1.76% (12/682) of patients with suspected neuropathy.
- The most common type of MG was IgM-κ, followed by IgG-κ, IgG-λ, and biclonal IgG-λ/IgA-κ.
- Elevated M-protein levels were observed, with some patients testing positive for various autoantibodies, including anti-MAG, anti-GD1b, anti-GM1, anti-cardiolipin, ANA, and ANCA.
Conclusions:
- The study identified MG in a small percentage of neuropathy patients.
- The presence of specific autoantibodies suggests potential autoimmune mechanisms.
- Further investigation into the pathogenic relationship between M-protein and autoantibodies in neuropathies is warranted.
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