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Cryoglobulinemic neuropathy: a pathological study

J M Vallat, R Desproges-Gotteron, M J Leboutet

    Annals of Neurology
    |August 1, 1980
    PubMed
    Summary
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    This study reports a rare case of myeloma neuropathy where cryoprecipitates, identified as cryoglobulin deposits, were found within the nerve's endoneurial space and blood vessels, causing nerve damage.

    Area of Science:

    • Neurology
    • Pathology
    • Immunology

    Background:

    • Multiple myeloma can present with various neurological complications.
    • Cryoglobulinemia, a condition involving abnormal proteins in the blood, is associated with certain hematological malignancies.
    • Neuropathy is a recognized, albeit less common, manifestation of multiple myeloma.

    Observation:

    • A 53-year-old woman with diagnosed myeloma and cryoglobulinemia developed symmetrical lower limb polyneuropathy.
    • Nerve biopsy revealed axonal degeneration and demyelination.
    • Electron microscopy identified tubular structures within the endoneurial space and vasa nervorum.

    Findings:

    • The observed tubular structures in the nerve biopsy were morphologically identical to cryoprecipitates from the patient's serum.

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  • These cryoprecipitate deposits were found in the endoneurial space and within the walls and lumen of nerve blood vessels (vasa nervorum).
  • This represents a novel finding of cryoglobulin deposition directly within nerve tissue in the context of myeloma.

    • Implications:

    • Cryoglobulin deposition in nerve tissue may be a direct mechanism contributing to neuropathy in myeloma patients.
    • Understanding this mechanism could lead to targeted therapies for myeloma-associated neuropathies.
    • This case highlights the importance of investigating cryoglobulinemia in patients with unexplained neuropathies and myeloma.