TITLE:
Central and peripheral neurological involvement in monoclonal gammopathies of undetermined significance
AUTHORS:
Edvina Galiè, Maria Luisa Dell’ Acqua, Marta Maschio, Tatiana Koudriavtseva, Emidio De Marco, Bruno Jandolo
KEYWORDS:
Multiple Sclerosis (MS); Monoclonal Gammopathies of Undetermined Significance (MGUS);Peripheral Nervous System (PNS) Involvement; Nervous System (CNS) Involvement Central
JOURNAL NAME:
World Journal of Neuroscience,
Vol.3 No.4,
October
10,
2013
ABSTRACT: Several
studies have suggested a pathogenetic role of paraproteinaemias in PNS damage.
Over the few last years, the presence of symptomatic or subclinical PNS lesions
in CNS diseases like multiple sclerosis has been described. On the other hand,
CNS demyelinating lesions and cervical atrophy have been re- ported in patients
affected by chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).
Very few cases of MGUS associated with CNS disease alone or with both CNS and
PNS disease have been re- ported. Since
1999, we
have been studying 16 patients (8 M, 8 F), with a mean age 60.2 ± 13.4,
affected by MGUS associated with symptomatic neurological central and/or peripheral diseases. Patients affected with lymphomas, lupus
erithematosus and other immunological diseases were excluded. Involvement of both PNS and
CNS was not associated to a particular type of paraproteinemia: monoclonal IgM were
found in 8 patients; monoclonal IgG in 6 patients and mono- clonal IgA in 1 patient
and Igl in 1 patient. High anti- nervous
system autoantibodies were found in 10/16 patients and antiMAG antibodies were
detected in patients with paraproteinemic demyelinating neuropathy (PDN). High
reactivity anti-nervous system might support the hypothesis of a pathogenetic
role of MGUS in these neurological diseases. Nevertheless, at present, we
cannot exclude that there is only a circumstantial association between MGUS and
neurological damages, particularly concerning CNS.