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NEUROLOGY 1983;33:192
© 1983 American Academy of Neurology

Monoclonal IgMK antibody precipitating with chondroitin sulfate C from patients with axonal polyneuropathy and epidermolysis

William H. Sherman, MD, Norman Latov, MD, PhD, Arthur P. Hays, MD, Masami Takatsu, MD, Rafaello Nemni, MD, Giuliana Galassi, MD and Elliott F. Osserman, MD

Departments of Medicine, Neuropathology, and Neurology, and the Cancer Research Center, College of Physicians and Surgeons, Columbia University, New York, NY

We studied two patients with an axonal type of polyneuropathy, epidermolysis, and IgMK plasma cell dyscrasia. The IgMK was deposited in the dermis, was absorbed from the serum by axonal micelle preparations, and was precipitated with chondroitin sulfate in highly purified agarose in 0.15 M NaCl with 0.01 M phosphate buffer, pH 7.8. In contrast, we found none of these abnormalities in three patients with IgM plasma cell dyscrasia and demyelinating neuropathy. Of 78 other macroglobulinemic serum samples from patients without neuropathy, 7 precipitated with a sulfated polysaccharide. This reaction occurred at low ionic strength, 0.05 M barbital buffer, pH 8.1, but did not occur in the higher ionic strength of 0.01 M phosphate with 0.15 M NaCl (PBS). The interaction of the IgM with chondroitin sulfate at relatively high ionic strength could cause both the axonal polyneuropathy and the epidermolysis.

Address correspondence and reprint requests to Dr. Sherman, Department of Medicine, Columbia University College of Physicians & Surgeons, 630 West 168th Street, New York, NY 10032.

Supported by grants Nos. CA-21112, CA-13696, and RR-00645 from the National Institutes of Health and a grant from the Muscular Dystrophy Association.

Accepted for publication June 21, 1982.




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