| Heterogeneous spectrum of neuropathies in Waldenström's macroglobulinemia: a diagnostic strategy to optimize their management. | |
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MedLine Citation:
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PMID: 22462670 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Karine Viala; Tanya Stojkovic; Anne-Violaine Doncker; Thierry Maisonobe; Timothée Lenglet; Gaëlle Bruneteau; Lucile Musset; Jean Neil; Jean-Marc Léger; Véronique Leblond |
Publication Detail:
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Type: JOURNAL ARTICLE |
Journal Detail:
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Title: Journal of the peripheral nervous system : JPNS Volume: 17 ISSN: 1529-8027 ISO Abbreviation: - Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-4-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9704532 Medline TA: J Peripher Nerv Syst Country: - |
Other Details:
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Languages: ENG Pagination: 90-101 Citation Subset: - |
Copyright Information:
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© 2012 Peripheral Nerve Society. |
Affiliation:
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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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