Waldenström's macroglobulinemia-associated retinopathy.

Abstract

OBJECTIVE:

To report the clinical, electrophysiologic, and immunopathologic findings in a patient with progressive retinal degeneration associated with Waldenström's macroglobulinemia.

DESIGN:

Case report with immunohistochemical studies.

METHODS:

A 46-year-old female with elevated serum immunoglobulin M (IgM) levels complained of photophobia and photopsias. Complete ophthalmic examinations including electrophysiologic testing and hematologic evaluations were performed over a 3-year period. Immunohistochemical studies to determine the presence of serum antiretinal antibodies were evaluated using confocal microscopy.

RESULTS:

Examination of the patient's fundus remained normal, although there was deterioration in her visual acuity, visual field, and electroretinogram over the follow-up period. Waldenström's macroglobulinemia was diagnosed by bone marrow biopsy. Indirect immunohistochemistry revealed reactivity of the patient's serum against the photoreceptor-connecting cilium.

CONCLUSION:

The paraneoplastic retinopathy associated with Waldenström's macroglobulinemia in this patient is presumed to result from antibodies of the IgM subtype reacting to proteins in the retinal photoreceptors.

• Authors: H Nida Sen, Chi-Chao Chan, Rafael C Caruso, Robert N Fariss, Robert B Nussenblatt, Ronald R Buggage
• Journal: Ophthalmology (Ophthalmology) Vol. 111 Issue 3 Pg. 535-9 (Mar 2004) ISSN: 0161-6420 [Print] United States
• PMID: 15019332 (Publication Type: Case Reports, Journal Article)

Chemical References

• Autoantibodies
• Autoantigens
• Immunoglobulin M

Topics

• Autoantibodies (blood)
• Autoantigens (immunology)
• Electroretinography
• Female
• Fluorescent Antibody Technique, Indirect
• Humans
• Immunoglobulin M (blood)
• Microscopy, Confocal
• Middle Aged
• Paraneoplastic Syndromes (diagnosis, etiology, physiopathology)
• Photophobia (etiology)
• Retina (immunology, physiopathology)
• Retinal Diseases (diagnosis, etiology, physiopathology)
• Visual Acuity (physiology)
• Visual Fields (physiology)
• Waldenstrom Macroglobulinemia (complications, diagnosis)