Instituut voor Neuropathische Pijn
English articles MGUS polyneuropathy and central nervous system
| MGUS polyneuropathy and central nervous system |
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We tend to think in MGUS polyneuropathy that only the peripheral nerves are involved. But the group of porfessor Hartung from the Heinrich Heine University in Germany looked whether there might be signs of central nervous system pathology. And indeed there was.
They focussed on a clinical triad of monoclonal gammopathy, polyneuropathy and signs of CNS involvement and looked for signs and symptoms in nineteen patients with monoclonal protein. They used clinical examination, MRI, cerebrospinal fluid analysis and immune reactivity against myelin-associated glycoprotein and gangliosides in serum. They found in 9 out of 19 patients (four IgM, five IgG) one or more clinical signs of CNS involvement. The IgM M-protein of two patients strongly stained the cortex/cerebellar neurons in human brain sections. In line with previous reports the group found that some patients with monoclonal gammopathy and polyneuropathy can develop problems in the central nervous system. Conclusion: It indicates that pathological effects of M-proteins are not necessarily restricted to the peripheral nervous system. The specificity and affinity of circulating M-protein to antigens in the CNS might be critical for the development of different clinical phenotypes. [1] March 2010, Jan M. Keppel Hesselink MD, PhD
Referenties[1]: Lehmann HC, Hoffmann FR, Meyer Zu Hörste G, Hartung HP, Kieseier BC. | Central nervous system involvement in patients with monoclonal gammopathy and polyneuropathy. | Eur J Neurol. | 2010 Aug;17(8):1075-81. Epub 2010 Mar 17. |