Skip to main content

Advertisement

Log in

Polymyositis and Polyneuropathy Associated with IgGk Monoclonal Gammopathy in Long COVID

  • Research
  • Published:
BioNanoScience Aims and scope Submit manuscript

Abstract

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to an increased recognition of its potential to induce neurological complications in the post-infection phase. This paper presents the case study of a 67-year-old male who experienced a severe SARS-CoV-2 infection, followed by the development of myopathy after 11–12 weeks and, subsequently, axonal polyneuropathy associated with IgG monoclonal gammopathies after 30 weeks. Comprehensive laboratory investigations, including serum tests, quantitative electromyography, and muscle biopsies analyzed under light microscopy, were conducted. The patient was followed for a period of 29 months (125 weeks) might offer a more active voice. The investigations unveiled persistent elevations in serum creatine kinase (CK) levels, serum M-protein IgG kappa, myopathic changes in quantitative electromyography, axonal sensorimotor polyneuropathy in nerve conduction studies, and histopathological alterations in muscle biopsies, such as lymphoplasmacytic infiltration and the presence of MHC I, CD4, and CD8 antibodies. Consequently, this paper reviews the clinical and pathological manifestations of polymyositis and polyneuropathy associated with IgG monoclonal gammopathy of clinical significance (MGCS–IgGk polyneuropathy) in the long-term post-COVID-19 period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Data Availability

The data are not publicly available due to restrictions; these datacontain information that could compromise the privacy of research participants. Requests to access the additional data should be addressed to the following email: mail@valentinamihajlova.ru.

References

  1. Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., Chang, J., Hong, C., Zhou, Y., Wang, D., Miao, X., Li, Y., & Hu, B. (2020). Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan China. JAMA Neurology, 77(6), 683–690. https://doi.org/10.1001/jamaneurol.2020.1127

    Article  Google Scholar 

  2. Portela-Sánchez, S., Sánchez-Soblechero, A., Melgarejo Otalora, P. J., Rodríguez López, Á., Velilla Alonso, G., Palacios-Mendoza, M. A., Cátedra Caramé, C., Amaya Pascasio, L., Mas Serrano, M., Massot-Tarrús, A., De La Casa-Fages, B., Díaz-Otero, F., Catalina, I., García Domínguez, J. M., Pérez-Sánchez, J. R., Muñoz-Blanco, J. L., & Grandas, F. (2021). Neurological complications of COVID-19 in hospitalized patients: The registry of a neurology department in the first wave of the pandemic. European Journal of Neurology, 28(10), 3339–3347. https://doi.org/10.1111/ene.14748

    Article  Google Scholar 

  3. Ghannam, M., Alshaer, Q., Al-Chalabi, M., Zakarna, L., Robertson, J., & Manousakis, G. (2020). Neurological involvement of coronavirus disease 2019: A systematic review. Journal of Neurology, 267(11), 3135–3153. https://doi.org/10.1007/s00415-020-09990-2

    Article  Google Scholar 

  4. Ferrandi, P. J., Alway, S. E., & Mohamed, J. S. (2020). The interaction between SARS-CoV-2 and ACE2 may have consequences for skeletal muscle viral susceptibility and myopathies. Journal of Applied Physiology (Bethesda, Md.: 1985), 129(4), 864–867. https://doi.org/10.1152/japplphysiol.00321.2020

    Article  Google Scholar 

  5. Priya, S. P., Sunil, P. M., Varma, S., Brigi, C., Isnadi, M. F. A. R., Jayalal, J. A., Shadamarshan, R. A., Kumar, S. S., Kumari, N. V., & Kumar, R. P. R. (2022). Direct, indirect, post-infection damages induced by coronavirus in the human body: An overview. Virusdisease, 33(4), 429–444. https://doi.org/10.1007/s13337-022-00793-9

    Article  Google Scholar 

  6. Dalakas, M. C. (2020). Inflammatory myopathies: Update on diagnosis, pathogenesis and therapies, and COVID-19-related implications. Acta Myologica: Myopathies and Cardiomyopathies: Official Journal of the Mediterranean Society of Myology, 39(4), 289–301. https://doi.org/10.36185/2532-1900-032

    Article  Google Scholar 

  7. Agergaard, J., Leth, S., Pedersen, T. H., Harbo, T., Blicher, J. U., Karlsson, P., Østergaard, L., Andersen, H., & Tankisi, H. (2021). Myopathic changes in patients with long-term fatigue after COVID-19. Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology, 132(8), 1974–1981. https://doi.org/10.1016/j.clinph.2021.04.009

    Article  Google Scholar 

  8. Hejbøl, E. K., Harbo, T., Agergaard, J., Madsen, L. B., Pedersen, T. H., Østergaard, L. J., Andersen, H., Schrøder, H. D., & Tankisi, H. (2022). Myopathy as a cause of fatigue in long-term post-COVID-19 symptoms: Evidence of skeletal muscle histopathology. European Journal of Neurology, 29(9), 2832–2841. https://doi.org/10.1111/ene.15435

    Article  Google Scholar 

  9. Agergaard, J., Yamin Ali Khan, B., Engell-Sørensen, T., Schiøttz-Christensen, B., Østergaard, L., Hejbøl, E. K., Schrøder, H. D., Andersen, H., Blicher, J. U., Holm Pedersen, T., Harbo, T., Tankisi, H., & MULTICOV Consortium. (2023). Myopathy as a cause of long COVID fatigue: Evidence from quantitative and single fiber EMG and muscle histopathology. Clinical Neurophysiology, 148, 65–75. https://doi.org/10.1016/j.clinph.2023.01.01010

    Article  Google Scholar 

  10. Swain, M., & Uppin, M. (2022). Evolving classification and role of muscle biopsy in diagnosis of inflammatory myopathies. Indian Journal of Pathology & Microbiology, 65(Supplement), S241–S251. https://doi.org/10.4103/ijpm.ijpm_1033_21

    Article  Google Scholar 

  11. Yu, H., He, D., Zhang, Q., Cao, B., Liu, W., & Wu, Y. (2022). Case Report: Monoclonal gammopathies of clinical significance-associated myopathy: A case-based review. Frontiers in Oncology, 12, 914379. https://doi.org/10.3389/fonc.2022.914379

    Article  Google Scholar 

  12. Marinelli, R., Sartorio, A., Muraro, V., Formenton, F., Pennetta, F., Simoni, E., Casoni, G. L., Mazza, A., Cuppini, S., & Camerotto, A. (2022). Presence of monoclonal components in SARS-CoV-2 patients: Preliminary data. A. Biochimica Clinica, 46(1), 58–61.

    Google Scholar 

  13. Vashistha, P., Gupta, A. K., Arya, M., Kumar Singh, V., Dubey, A., & Chandra Koner, B. (2020). Biclonal gammopathay in a case of severe COVID-19. Clinica Chimica Acta; International Journal of Clinical Chemistry, 511, 342–345. https://doi.org/10.1016/j.cca.2020.10.040

    Article  Google Scholar 

  14. Chaudhry, H. M., Mauermann, M. L., & Rajkumar, S. V. (2017). Monoclonal gammopathy-associated peripheral neuropathy: Diagnosis and management. Mayo Clinic Proceedings, 92(5), 838–850. https://doi.org/10.1016/j.mayocp.2017.02.003

    Article  Google Scholar 

  15. Gorson, K. C., & Ropper, A. H. (1997). Axonal neuropathy associated with monoclonal gammopathy of undetermined significance. Journal of Neurology, Neurosurgery, and Psychiatry, 63(2), 163–168. https://doi.org/10.1136/jnnp.63.2.163

    Article  Google Scholar 

Download references

Funding

This paper was supported by the Kazan Federal University Strategic Academic Leadership Program (PRIORITY-2030).

Author information

Authors and Affiliations

Authors

Contributions

D.D. original idea, first draft, final manuscript writing. V.M. draft correction and supervision of the project. G.L., E.K., A.L., A.P., E.M., A.B. draft revision. O.G., A.G. and N.K. data providing. All authors reviewed the manuscript.

Corresponding author

Correspondence to Valentina Mikhailova.

Ethics declarations

Informed Consent

Informed consent was signed by the patient before the procedure.

Competing Interests

The authors declare no competing interests.

Research Involving Humans and Animals

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Degterev, D., Mikhailova, V., Bilyalov, A. et al. Polymyositis and Polyneuropathy Associated with IgGk Monoclonal Gammopathy in Long COVID. BioNanoSci. (2024). https://doi.org/10.1007/s12668-024-01414-z

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12668-024-01414-z

Keywords

Navigation