Chronic demyelinating neuropathy with anti-myelin-associated glycoprotein antibody without any detectable M-protein

  • Yuki Sakamoto
  • Toshio Shimizu
  • Shinsuke Tobisawa
  • Eiji Isozaki
Original Article
  • 148 Downloads

Abstract

Previous case reports and studies have shown that anti-myelin-associated glycoprotein (MAG) antibody can be detected in patients with polyneuropathy without any detectable M-protein. Nevertheless, the frequency of and related factors have not yet been adequately investigated. The objectives of this study are to examine the prevalence of anti-MAG antibody in patients with demyelinating neuropathy without M-protein and to determine their clinical characteristics. From January, 2004, to September, 2016, consecutive patients with chronic demyelinating neuropathy were recruited. Anti-MAG antibody presence was tested at the first evaluation. We determined the prevalence of anti-MAG antibody without M-protein among included patients and evaluated the clinical characteristics. A total of 44 patients were included in the present study (12 women; median age at first visit 60 years [interquartile range 47–67 years]; median duration between onset and first visit 9 months [3–26 months]). M-protein was found in eight patients (18%) at the first evaluation. Anti-MAG antibody was present in 2 of remaining 36 (5.6 [95% confidence interval 0–13.0] %) patients without M-protein. Patients with anti-MAG antibody exhibited slowly progressive and distal dominant neuropathy with elevated serum IgM levels and refractory to immunotherapy. There were no differences in clinical features between patients having anti-MAG antibody without M-protein, and those with M-protein. One patient with the anti-MAG antibody showed a delayed appearance of M-protein during a 4-year follow-up after diagnosis. The prevalence of the anti-MAG antibody in chronic demyelinating neuropathy without any detectable M-protein was 5.6%. Anti-MAG antibody may be detectable earlier than M-protein.

Keywords

Myelin-associated glycoprotein Anti-MAG antibody Chronic inflammatory demyelinating polyradiculoneuropathy M-protein 

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Copyright information

© Springer-Verlag Italia S.r.l. 2017

Authors and Affiliations

  1. 1.Department of NeurologyTokyo Metropolitan Neurological HospitalFuchuJapan
  2. 2.Department of Neurological Science, Graduate School of MedicineNippon Medical SchoolTokyoJapan

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