NEUROPATHY ASSOCIATED WITH MONOCLONAL GAMMOPATHIES OF UNDETERMINED SIGNIFICANCE
NEUROPATHY ASSOCIATED WITH MONOCLONAL GAMMOPATHIES OF UNDETERMINED SIGNIFICANCE
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DOI：
10.1002/ana.410300111
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发表时间：
1991-07-01
影响因子：
11.2
通讯作者：
DYCK, PJ
中科院分区：
文献类型：
--
作者：
GOSSELIN, S;KYLE, RA;DYCK, PJ
神经病患者血清或尿液中的单克隆蛋白（IgM、IgG和伊加）可作为淀粉样变性、骨髓瘤、淋巴瘤、白血病、瓦尔登斯特伦巨球蛋白血症或意义不明的单克隆丙种球蛋白病（MGUS）的标志物。本文比较了1980 ~ 1986年间与单克隆IgM（IgM-MGUS，31例）、单克隆IgG（IgG-MGUS，24例）和单克隆伊加（IgA-MGUS，10例）相关的神经病的临床特征、病程和肌电图特征。四个统计学显著差异将IgM-MGUS神经病与IgG-MGUS和IgA-MGUS神经病分开：（1）感觉丧失和共济失调的频率较高，（2）神经传导异常的频率较高-10个属性明显变差（无明显改善），（3）复合肌肉动作电位离散频率较高，和（4）在MGUS神经病组群中IgM-MGUS的频率高于在我们的机构中观察到的无神经病的MGUS特征或流行病学调查中遇到的。这些差异不被认为是由于选择或严重性偏倚。IgM的量和单克隆峰的估计大小都与神经病变的严重程度无关。抗髓磷脂相关糖蛋白抗体阳性的IgM-MGUS神经病变的类型和严重程度与无抗髓磷脂相关糖蛋白抗体的IgM-MGUS神经病变无显著差异。不能假设IgM-MGUS或抗髓鞘相关糖蛋白抗体的存在和数量与神经病变之间存在简单的关系。
Monoclonal proteins (IgM, IgG, and IgA) in the serum or urine of patients with neuropathy may provide a marker for amyloidosis, myeloma, lymphoma, leukemia, Waldenstrom's macroglobulinemia, or monoclonal gammopathy of undetermined significance (MGUS). The clinical characteristics, course, and electromyographic features among neuropathies associated with monoclonal IgM (IgM-MGUS, 31 patients), monoclonal IgG (IgG-MGUS, 24 patients), and monoclonal IgA (IgA-MGUS, 10 patients) evaluated between 1980 and 1986 were compared. Four statistically significant differences set IgM-MGUS neuropathies apart from IgG-MGUS and IgA-MGUS neuropathies: (1) higher frequency of sensory loss and ataxia, (2) higher frequency of nerve conduction abnormality-10 attributes were significantly worse (none were significantly better), (3) higher frequency of dispersion of the compound muscle action potential, and (4) higher frequency of IgM-MGUS in the MGUS neuropathy cohort than is characteristic of MGUS without neuropathy seen at our institution or than is encountered in epidemiological surveys. These differences were not thought to be due to selection or severity biases. Neither the amount of IgM nor the estimated size of the monoclonal peak was associated with severity of neuropathy. The type and severity of IgM-MGUS neuropathies with anti-myelin-associated glycoprotein antibodies were not significantly different from those without anti-myelin-associated glycoprotein antibodies. A simple relationship between the presence and amount of IgM-MGUS or anti-myelin-associated glycoprotein antibodies and neuropathy cannot be assumed.