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Polyneuropathie bei monoklonaler Gammopathie unbestimmter Signifikanz (MGUS)

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Immunglobuline in der klinischen Neurologie

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Zusammenfassung

Monoklonale Gammopathien entstehen durch Proliferation von B-Zellen, die exzessiv monoklonale Immunglobuline (Paraproteine, M-Proteine) produzieren. Dies kann im Rahmen maligner Erkrankungen (multiples Myelom, M. Waldenstrom, B-Zell-Lymphom, chronisch-lymphatische Leukämie) oder ohne Hinweis auf ein malignes Geschehen auftreten. Wenn eine maligne hämatologische Systemerkrankung oder eine Amyloidose ausgeschlossen sind, wird von „benigner monoklonaler Gammopathie“ oder, einem Vorschlag von Kyle [6] entsprechend, von einer „monoklonalen Gammopathie unbestimmter Signifikanz (MGUS)“ gesprochen. Dies ist gerechtfertigt, da sie zum einen bei 20–30% der Patienten nach Jahren doch noch in eine maligne Form fortschreitet und zum anderen schwere Polyneuropathien bei monoklonaler Gammopathie beobachtet werden, die die Bezeichnung „benigne“ als irreführend erscheinen lassen.

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Literatur

  1. Cook D, Dalakas MC, Galdi A, Biondi D, Porter H (1990) High-dose intravenous immunoglobulin in the treatment of demyelinating neuropathy associated with monoclonal gammopathy. Neurology 40:212–214

    PubMed  CAS  Google Scholar 

  2. Dalakas MC (1999) Intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: present status and practical therapeutic guidelines. Muscle Nerve 22:1479–1497

    Article  PubMed  CAS  Google Scholar 

  3. Dalakas MC, Quarles RH, Farrer RG, Dambrosia J, Soueidan S, Stein DP, Cupler EJ, Sekul EA, Otero C (1996) A controlled study of intravenous immunoglobulin in demyelinating neuropathy with IgM gammopathy. Ann Neurol 40:792–795

    Article  PubMed  CAS  Google Scholar 

  4. Dyck PJ, Low PA, Windebank AJ et al (1991) Plasma exchange in polyneuropathy associated with monoclonal gammopathy of undetermined significance. N Engl J Med 325:1482–1486

    Article  PubMed  CAS  Google Scholar 

  5. Greten H, Schettler G (2000) Innere Medizin. Thieme, Stuttgart New York

    Google Scholar 

  6. Kyle RA (1984) ‘Benign’ monoclonal gammopathy: a misnomer? JAMA 251:1849–1854

    Article  PubMed  CAS  Google Scholar 

  7. Latov N (1995) Pathogenesis and therapy of neuropathies associated with monoclonal gammopathies. Ann Neurol 37:S32–42

    Article  PubMed  Google Scholar 

  8. Leger JM, Oksenhendler E, Bussel A et al (1993) Treatment by chlorambucil with/ without plasma exchanges of polyneuropathy associated with monoclonal IgM. Prospective randomized study in 44 patients. Neurology 43:A215

    Google Scholar 

  9. Miescher GC, Steck AJ (1996) Paraproteinaemic neuropathies. Baillière’s Clinical Neurology 5:219–232

    PubMed  CAS  Google Scholar 

  10. Nobile-Orazio E, Manfredini E, Carpo M et al (1994) Frequency and clinical correlates of anti-neural IGM antibodies in neuropathy associated with IgM monoclonal gammopathy. Ann Neurol 36:416–424

    Article  PubMed  CAS  Google Scholar 

  11. Notermans NC, Wokke JH, Lokhorst HM, Franssen H, van der Graaf Y, Jennekens FG (1994) Polyneuropathy associated with monoclonal gammopathy of undetermined significance. A prospective study of the prognostic value of clinical and laboratory abnormalities. Brain 117:1385–1393

    Article  PubMed  Google Scholar 

  12. Ropper AH, Gorson KC (1998) Neuropathies associated with paraproteinemia. N Engl J Med 338:1601–1607

    Article  PubMed  CAS  Google Scholar 

  13. Suarez GA, Kelly JJ (1993) Polyneuropathy associated with monoclonal gammopa-thy of undetermined significance: further evidence that IgM-MGUS neuropathies are different than IgG-MGUS. Neurology 43:1304–1308

    PubMed  CAS  Google Scholar 

  14. Thomas PK, Willison HJ (1994) Paraproteinaemic neuropathy. Baillière’s Clinical Neurology 3:129–147

    PubMed  CAS  Google Scholar 

  15. Weilbach FX, Gold R (1999) Pathogenese, Diagnostik und Therapie von Autoimmunneuropathien. In: Zettl UK, Mix E (Hrsg) Klinische Neuroimmunologie: Aktuelle Aspekte. De Gruyter, Berlin New York, S 175–195

    Google Scholar 

  16. Wilson HC, Lunn MP, Schey S, Hughes RA (1999) Successful treatment of IgM paraproteinaemic neuropathy with fludarabine. J Neurol Neurosurg Psychiatry 66:575–580

    Article  PubMed  CAS  Google Scholar 

  17. Yeung KG, Thomas PK, King RHM et al (1991) The clinical spectrum of peripheral neuropathies associated with benign monoclonal IgM, IgG and IgA para-proteinaemia. Comparative clinical, immunological and nerve biopsy findings. J Neurol 238:383–391

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. A. Engelhardt
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Editors and Affiliations

  1. Neurologische Klinik mit Klinischer Neurophysiologie, Alfried Krupp Krankenhaus, Alfried-Krupp-Straße 21, 45117, Essen, Deutschland

    Peter Berlit

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© 2001 Steinkopff Verlag Darmstadt

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Engelhardt, A. (2001). Polyneuropathie bei monoklonaler Gammopathie unbestimmter Signifikanz (MGUS). In: Berlit, P. (eds) Immunglobuline in der klinischen Neurologie. Steinkopff. https://doi.org/10.1007/978-3-642-93716-3_8

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  • DOI: https://doi.org/10.1007/978-3-642-93716-3_8

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-93717-0

  • Online ISBN: 978-3-642-93716-3

  • eBook Packages: Springer Book Archive

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