Treatment of polyneuropathy in Waldenström's macroglobulinemia: role of paraproteinemia and immunologic studies.

Abstract

A patient with polyneuropathy due to Waldenström's macroglobulinemia (WM) was treated successfully with chlorambucil and prednisone. Before therapy, 60% of peripheral lymphocytes were B cells, the nerve had IgM-bearing B-cell infiltrates, and the circulating IgM had antibody-binding activity to autologous and homologous nerves. Neurologic improvement, sustained for 4 years, began 3 months after therapy and coincided with the return to normal of bone marrow and circulating B cells. Binding of IgM to autologous and homologous nerves persisted after therapy, suggesting that not the IgM alone but other B-cell factors, possibly complexed to IgM, may have been responsible for the nerve damage.

• Authors: M C Dalakas, M A Flaum, M Rick, W K Engel, H R Gralnick
• Journal: Neurology (Neurology) Vol. 33 Issue 11 Pg. 1406-10 (Nov 1983) ISSN: 0028-3878 [Print] United States
• PMID: 6314179 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulin M
• Chlorambucil
• Prednisone

Topics

• B-Lymphocytes (immunology)
• Chlorambucil (therapeutic use)
• Female
• Humans
• Immunoglobulin M (immunology)
• Middle Aged
• Neurons (immunology)
• Peripheral Nervous System Diseases (complications, drug therapy, immunology)
• Prednisone (therapeutic use)
• Waldenstrom Macroglobulinemia (complications, drug therapy, immunology)