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Waldenstrom's macroglobulinemia and neuropathy

Deposition of M-component on myelin sheaths

Division of Hematology, Department of Medicine and the Department of Neurology, Albany Medical College of Union University (Drs. Propp, Means, and Barron), and the Division of Laboratories and Research and the Kidney Disease Institute, New York State Department of Health (Drs. Deibel and Sherer), Albany, New York.

Chronic idiopathic polyneuropathy of a primary demyelinating type developed in a man who had had recurrent herpes simplex 2 for 10 years. A serum IgM kappa M-component was demonstrated on the myelin of individual sural nerve fibers by direct immunofluorescence microscopy. Marrow lymphocytosis and serum M-component increased with time. Attempts to confirm antibody activity of the M-component were negative. The evidence suggests that the attachment of M-component to nerve is a physical-chemical one. Interaction of M-component and nerve appears to have led to the neuropathy as an early manifestation of Waldenstrom's macroglobulinemia.

Supported in part by a grant from the Manning Foundation, by grant 775-B-2 of the National Multiple Sclerosis Foundation, and by Veterans Administration Research Project 0822-01.

Received for publication March 6, 1975.

Requests for reprints should be addressed to Dr. Propp, Albany Medical College, Albany, NY 12208.

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