期刊
MICRON
卷 39, 期 2, 页码 61-70出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.micron.2006.12.005
关键词
nerve biopsy; electron microscopy; IgG monoclonal gammopathy; neuropathies; chronic inflammatory demyelinating polyneuropathy (CIDP); amyloidosis; endoneurial deposits; MGUS; lymphoma; myeloma
类别
A typical monoclonal IgG dysglobulinemia whether benign (monoclonal gammopathy of undetermined significance, MGUS) or malignant can give rise to peripheral neuropathy by damaging nerves. At first, neurotoxicity of the chemotherapy if the patient is treated must be ruled out in such cases. Indeed, a variety of other mechanisms have been described: endoneurial deposits of immunoglobulin, infiltration of the immunoglobulin within myelin sheaths, POEMS syndrome, deposits of amyloid, chronic inflammatory demyelinating polyradiculoneuropathy and infiltration of malignant cells. Ultrastructural examination of a nerve biopsy can be decisive in combination with routine histological and immunopathological examinations. Characterization of the mechanism of the neuropathy in a dysglobulinemic context is important as it governs therapeutic options, which in certain cases are particularly beneficial. (C) 2007 Elsevier Ltd. All rights reserved.
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