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[Late-onset multiple sclerosis and serum monoclonal gammopathy: an incidental association?]
S Tréfouret1, J P Azulay, J Pouget
1Service de Neurologie et Maladies Neuromusculaires, CHU La Timone, Marseille.
Abstract:
Four patients older than 45 years with a central nervous system demyelinating disease associated to a monoclonal gammopathy are reported. The neurologic disease met the diagnostic criteria of multiple sclerosis, with the particularity of a late onset. Monoclonal paraproteinemia was also present in the cerebrospinal fluid, associated with an intrathecal immunoglobulin synthesis. The clinical data and the course of the disease were comparable to the previous reports of late onset multiple sclerosis. A causal link between the dysglobulinemia and the neurological disease may not be demonstrated. However, such an association may underline the role of humoral processes in multiple sclerosis.
Insights
Late-onset multiple sclerosis (MS) in patients over 45 with monoclonal gammopathy suggests a potential link. This association highlights the role of humoral processes in MS pathogenesis.
Area of Science:
- Neurology
- Immunology
Context:
- Central nervous system demyelinating diseases
- Monoclonal gammopathy
- Late-onset multiple sclerosis
Purpose:
- To report on four patients over 45 with central nervous system demyelinating disease and monoclonal gammopathy.
- To analyze the clinical presentation and disease course in these patients.
- To explore the potential association between monoclonal gammopathy and late-onset MS.
Summary:
- Four patients older than 45 years presented with central nervous system demyelinating disease meeting multiple sclerosis criteria, but with late onset.
- Monoclonal paraproteinemia was detected in cerebrospinal fluid, indicating intrathecal immunoglobulin synthesis.
- Clinical data and disease progression were similar to previously reported cases of late-onset MS.
Impact:
- The findings suggest a potential association between monoclonal gammopathy and late-onset multiple sclerosis.
- This association may provide insights into the role of humoral immune processes in the development or progression of MS.
- Further research is warranted to establish a causal link and understand the underlying mechanisms.