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Dysproteinemic Neuropathies

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Biopsy Diagnosis of Peripheral Neuropathy

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Abstract

A significant association exists between the presence of circulating monoclonal immunoglobulins and peripheral neuropathy (NAP, neuropathy associated with paraproteinemia, is used throughout this chapter). In large series a paraprotein has been found in 5–10 % of otherwise idiopathic neuropathies; conversely, a neuropathy is seen in up to 58 % of patients with paraproteinemia (Read et al. 1978; Kelly et al. 1981a; Osby et al. 1982; Isobe and Osserman 1971; Vrethem et al. 1993; Walsh 1971; Smith et al. 1983; Ramchandren 2012). In some cases the clinicopathological features of NAP suggests a causal relationship, while in others the significance of the association remains to be determined. The circulating paraprotein can be seen as part of several well-defined diseases, or may be present in isolation, with the frequency of neuropathy depending on the underlying disease, but, more importantly, on the particular type of paraprotein heavy or light chain. Table 14.1 lists the dysproteinemias associated with neuropathy (Kyle 1992).

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Authors and Affiliations

  1. Sunnybrook and St Michael’s Hospitals, University of Toronto, Toronto, ON, Canada

    Juan M. Bilbao MD, FRCP (C) (Professor Emeritus of Neuropathology)

  2. Division of Neuropathology Department of Pathology, Washington University School of Medicine, St. Louis, MO, USA

    Robert E. Schmidt MD, PhD (Professor of Pathology and Immunology Director)

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  1. Juan M. Bilbao MD, FRCP (C)
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  2. Robert E. Schmidt MD, PhD
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Bilbao, J.M., Schmidt, R.E. (2015). Dysproteinemic Neuropathies. In: Biopsy Diagnosis of Peripheral Neuropathy. Springer, Cham. https://doi.org/10.1007/978-3-319-07311-8_14

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