Les polyneuropathies avec IgM monoclonale anti-MAG : étude descriptive clinique, biologique, électrophysiologique et anatomopathologique d'une cohorte de 13 patients [Anti-MAG paraproteinemic demyelinating polyneuropathy: a clinical, biological, electrophysiological and anatomopathological descriptive study of a 13-patients' cohort]

Détails

ID Serval
serval:BIB_9157293F0804
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Les polyneuropathies avec IgM monoclonale anti-MAG : étude descriptive clinique, biologique, électrophysiologique et anatomopathologique d'une cohorte de 13 patients [Anti-MAG paraproteinemic demyelinating polyneuropathy: a clinical, biological, electrophysiological and anatomopathological descriptive study of a 13-patients' cohort]
Périodique
Revue neurologique
Auteur⸱e⸱s
Launay M., Delmont E., Benaim C., Sacconi S., Butori C., Desnuelle C.
ISSN
0035-3787 (Print)
ISSN-L
0035-3787
Statut éditorial
Publié
Date de publication
12/2009
Peer-reviewed
Oui
Volume
165
Numéro
12
Pages
1071-1079
Langue
français
Notes
Publication types: English Abstract ; Journal Article
Publication Status: ppublish
Résumé
Polyneuropathies associated with IgM paraproteinemia and anti-myelin associated glycoprotein (MAG) antibodies (MAG-PN) have to be differentiated from chronic inflammatory demyelinating polyneuropathies.
In a retrospective study, we have analyzed clinical, electrophysiological, biological and pathological data from MAG-PN patients.
Seven male and six female patients were followed in the department for a mean 2 years (0.5-6.5 years). Mean age at diagnosis was 61 years (44.5-85.5 years). Patients had symmetrical bilateral paresthesia (11/13) and hypoesthesia (11/13) prominent in the lower limbs. Nine patients developed gait ataxia and four patients had moderate distal weakness in the lower limbs. Mean Overall Neuropathy Limitation Scale was 2.3 (0-5). Nerve conduction study showed demyelinating features though delayed distal motor latency on median (206 % of normal value) and ulnar nerves (150% of normal value). Seven out of thirteen patients had at least two nerves with terminal latency index below 0.25. IgM paraproteinemia was of undetermined significance in ten cases and three patients had non-Hodgkin lymphoma. IgM deposits and widening of the peripheral myelin were observed in 5/7 sural nerve biopsies. Anti-MAG antibodies were detected in the sera of all patients using enzyme-linked immunosorbent assay and in 8/12 patients using western blot analysis.
MAG-PN have distinctive clinical, electrophysiological and pathological features. It is a chronic, slowly progressive, predominantly sensory and ataxic neuropathy. Disability is usually moderate. Electrophysiological study shows distal demyelinating process and is highly suggestive of MAG-PN in more than one half of our patients. Several techniques may detect anti-MAG antibodies, they have to be associated to improve sensitivity and specificity of the test.
Mots-clé
Adult, Aged, Aged, 80 and over, Cohort Studies, Demyelinating Diseases/complications, Demyelinating Diseases/pathology, Demyelinating Diseases/physiopathology, Female, Gait Ataxia/epidemiology, Humans, Immunoglobulin M/blood, Lymphoma, Non-Hodgkin/epidemiology, Male, Middle Aged, Neural Conduction/physiology, Paraproteinemias/complications, Paraproteinemias/pathology, Paraproteinemias/physiopathology, Paresthesia/epidemiology, Reaction Time
Pubmed
Web of science
Création de la notice
29/11/2018 9:08
Dernière modification de la notice
20/08/2019 14:54
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