Document Detail


Heterogeneous spectrum of neuropathies in Waldenström's macroglobulinemia: a diagnostic strategy to optimize their management.
MedLine Citation:
PMID:  22462670     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Neuropathy in Waldenström's macroglobulinemia (WM) is very heterogeneous. We retrospectively studied 40 patients with WM and neuropathy to analyze the different presentations and mechanisms encountered and to propose a diagnostic strategy. Twenty-five patients (62.5%) had axonal neuropathy, related to the following mechanisms: amyloid neuropathy (n = 5), cryoglobulinemic neuropathy (n = 5), neuropathy associated with tumoral infiltration (n = 2), vasculitic neuropathy (n = 2), a clinical motor neuropathy possibly of dysimmune origin (n = 6), or an unclassified mechanism (n = 5). A demyelinating pattern was observed in 15 patients, 10 having anti-myelin-associated glycoprotein (anti-MAG) antibodies and 5 having neuropathy related to chronic inflammatory demyelinating polyradiculoneuropathy. On the basis of these results, we propose a diagnostic strategy combining: (1) an EMG to distinguish between a demyelinating and an axonal pattern; (2) measurement of anti-MAG and anti-ganglioside antibodies; (3) screening for "red flag" features to orientate further investigations. This strategy may help clinicians to identify the mechanism of neuropathy in order to adapt the therapeutic strategy.
Authors:
Karine Viala; Tanya Stojkovic; Anne-Violaine Doncker; Thierry Maisonobe; Timothée Lenglet; Gaëlle Bruneteau; Lucile Musset; Jean Neil; Jean-Marc Léger; Véronique Leblond
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Journal of the peripheral nervous system : JPNS     Volume:  17     ISSN:  1529-8027     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-4-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9704532     Medline TA:  J Peripher Nerv Syst     Country:  -    
Other Details:
Languages:  ENG     Pagination:  90-101     Citation Subset:  -    
Copyright Information:
© 2012 Peripheral Nerve Society.
Affiliation:
Département de Neurophysiologie Clinique; Département des Maladies du Système Nerveux Centre de Référence de Pathologie Neuromusculaire Paris Est Département d'Hématologie Département de Neuropathologie R Escourolle Laboratoire d'Immunochimie, Université Paris VI, Pierre et Marie Curie, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
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