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Sensorimotor Polyneuropathy in Light Chain Multiple Myeloma

  • G. Pellegrini
  • G. Scarlato
  • M. Moggio
  • C. Bettinelli
  • S. M. Gaini
Part of the Acta Neuropathologica Supplementum book series (NEUROPATHOLOGIC, volume 7)

Summary

The authors describe an adult onset sensorimotor polyneuropathy in a woman with light chain K-type myeloma. Neurophysiological investigation showed a severe reduction of conduction velocity of the peripheral nerve to the four limbs. A muscle and sural nerve biopsy were performed. Sural nerve displayed a severe loss of myelinated and unmyelinated fibers. No amyloid deposit was observed in vessels, perineurium and endomysium by electron microscopy examination. No onion bulb formation was present in nerve tissue, but many demyelinated fibers were surrounded by cir-cumferentially disposed Schwann cell processes without any interposition of collagen fibrils. Some fibers exhibit signs of active remyelination; axonal alterations were rarely seen. Collagen pockets were frequently observed among proliferated collagen fibrils. The mechanism of peripheral nerve lesions in various categories of multiple myeloma is till now an unsolved problem. In this case the unusual association with a light chain myeloma suggest that these immunoglobulins play a role in the pathogenesis of the polyneuropathy as supported by experimental studies.

Key words

myeloma polyneuropathy immunoglobulin 

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References

  1. 1.
    Chazot G, Berger B, Carrier H, Barbaret C, Bady B, Dumas R, Creyssel R, Schott B (1976) Manifestations neurologiques des gammapathies monoclonales. Rev Neurol (Paris) 132: 195–212Google Scholar
  2. 2.
    Dalakas MC, Engel WK (1979) Role of immunoglobulin light chains in the pathogenesis of amyloid polyneuropathy associated with occult plasma cell dyscrasia. Ann Neurol 6:163Google Scholar
  3. 3.
    Dayan AD, Stokes (1972) Peripheral neuropathy and experimental in the mouse. Nature (new biology) 236:117–118CrossRefGoogle Scholar
  4. 4.
    Julien J, Vital C, Vallat JM, Langueny A, Deminiere C, Darriet D (1978) Polyneuropathy in Waldenstrom’s macroglobulinemia. Arch Neurol 35:423–425PubMedCrossRefGoogle Scholar
  5. 5.
    Ochoa J, Mair WGP (1969) The normal sural nerve in man I and II. Acta Neuropathol (Berl) 13:197–239CrossRefGoogle Scholar
  6. 6.
    Propp P, Means E, Deibel R, Sherer G, Barron L (1975) Waldenstrom’s macroglobulinemia and neuropathy. Neurology (Minneap) 25:980–988Google Scholar
  7. 7.
    Stone MJ, Frenkel EP (1975) The clinical spectrum of light chain myeloma. Am J Med 58: 601–619PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1981

Authors and Affiliations

  • G. Pellegrini
    • 1
    • 4
  • G. Scarlato
    • 1
  • M. Moggio
    • 1
  • C. Bettinelli
    • 3
  • S. M. Gaini
    • 2
  1. 1.Neurological Department, Medical SchoolUniversity of MilanMilanItaly
  2. 2.Neurosurgical Department, Medical SchoolUniversity of MilanMilanItaly
  3. 3.Internal Medicine Department, Medical SchoolUniversity of MilanMilanItaly
  4. 4.Clinica Neurologica Pad. PontiMilanoItaly

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