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Current Neurology and Neuroscience Reports
Published in: Current Neurology and Neuroscience Reports 1/2012

01-02-2012 | Nerve and Muscle (M Hirano and LH Weimer, Section Editors)

An Update on Monoclonal Gammopathy and Neuropathy

Authors: Sindhu Ramchandren, Richard A. Lewis

Published in: Current Neurology and Neuroscience Reports | Issue 1/2012

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Abstract

Peripheral neuropathy associated with monoclonal gammopathy is a rare but important cause of neuropathy that can herald serious underlying disease. IgM monoclonal gammopathy of undetermined significance (MGUS) is the most commonly found monoclonal gammopathy associated with neuropathy, with characteristic clinical, electrophysiologic, and pathologic features. The IgG and IgA monoclonal gammopathies are rarely associated with specific neuropathies. Standard immunomodulatory agents including steroids, intravenous immunoglobulin, and plasmapheresis have shown limited efficacy in IgM MGUS. Neuropathies associated with specific lymphoproliferative disorders may not respond to treatments aimed at that disorder. Case series had shown promising results with rituximab, a monoclonal antibody that targets the B cell surface antigen CD20 and results in a rapid and sustained depletion of B cells; however, two recent randomized controlled trials with rituximab failed to provide evidence of efficacy in primary outcome measures, despite reduction in antibody levels. Long-term studies looking at the association between specific immunologic markers and disease recurrence are needed to ultimately develop targeted therapies.
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Metadata
Title
An Update on Monoclonal Gammopathy and Neuropathy
Authors
Sindhu Ramchandren
Richard A. Lewis
Publication date
01-02-2012
Publisher
Current Science Inc.
Published in
Current Neurology and Neuroscience Reports / Issue 1/2012
Print ISSN: 1528-4042
Electronic ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-011-0237-4

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