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Peripheral neuropathy in macroglobulinemia

Incidence and antigen-specificity of M proteins

"Dino Ferrari" Center for Neuromuscular Diseases, Institute of Clinical Neurology (Drs. Nobile-Orazio, Marmiroli, Spagnol, Barbieri, Moggio, and Scarlato), and the Institute of Clinical Medicine I° (Drs. Baldini, N. Polli, and E. Polli), University of Milan, Milan, Italy.

Peripheral neuropathy was found in 12 (46%) of 26 patients with macroglobulinemia. The neuropathy was subclinical in two. Anti-myelin-associated glycoprotein (MAG) activity was found in six (50%) patients with neuropathy. Sural nerve biopsies showed demyelination and IgM deposits on the myelin sheath. In one patient who had no anti-MAG activity, the serum IgM bound to peripheral myelin by indirect immunofluorescence and to several protein bands in peripheral nerve and other tissues by immunoblot. In the other five patients with neuropathy, we found no binding of M proteins to nerve components, but in three patients there were endoneurial IgM deposits in nerve biopsy. Peripheral neuropathy may be related to the antigen-specificity of M proteins.

Address correspondence and reprint requests to Dr. Nobile-Orazio, Institute of Clinical Neurology, University of Milan, Via Francesco Sfona 35, 20122, Milan, Italy.

Supported by the "Associazione Amici Centro Din0 Ferrari."

Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.

Received August 11, 1986. Accepted for publication in final form December 24, 1986.

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