Summary
Histological, immunohistochemical and ultrastructural sural nerve and skin biopsy findings in a case of cryoglobulinemia secondary to an IgM-kappa-producing non-Hodgkin lymphoma are described. The main finding was an occlusive microangiopathy present in both the sural nerve and the skin. Widespread cryoglobulin deposits of the proliferated vasa nervorum were associated with pronounced changes probably evoked by ischemia. Moderate perivascular inflammation, but no florid vasculitis was additionally present. Our observations indicate that occlusive microangiopathy by precipitated cryoglobulins may be a relevant pathogenetic factor in cryoglobulinemic peripheral neuropathy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Brouet J-C, Clauvel J-P, Danon F, Klein M, Seligmann M (1974) Biological and clinical significance of cryoglobulins. A report of 86 cases. Am J Med 57:775–788
Chad D, Pariser K, Bradley WG, Adelman LS, Pinn VW (1982) The pathogenesis of cryoglobulinemic neuropathy. Neurology 1982:725–729
Cream JJ, Hern JEC, Hughes RAC, MacKenzie ICK (1974) Mixed or immune complex cryoglobulinemia and neuropathy. J Neurol Neurosurg Psychiatry 37:82–87
Dayan AD, Lewis PD (1966) Demyelinating neuropathy in macroglobulinemia. Neurology 16:1141–1144
Konishi T, Saida K, Ohnishi A, Nishitani H (1982) Perineuritis in mononeuritis multiplex with cryoglobulinemia. Muscle Nerve 9:173–177
Lippa CF, Chad DA, Smith TW, Kaplan MH, Hammer K (1986) Neuropathy associated with cryoglobulinemia. Muscle Nerve 9:626–631
Logothetis J, Kennedy WR, Ellington A, Williams RC (1968) Cryoglobulinemic neuropathy: incidence and clinical characteristics. Arch Neurol 19:389–397
McLeod JG, Walsh JC, Pollard JD (1984) Neuropathies associated with paraproteinemias and dysproteinemias. In: Dyck PT, Thomas PK, Lambert EH, Bunge R (eds) Peripheral neuropathy, 2nd edn. Saunders Philadelphia, pp 1847–1865
Nemni R, Corbo M, Fazio R, Quattrini A, Comi G, Canal N (1988) Cryglobulinaemic neuropathy. A clinical, morphological and immunocytochemical study of 8 cases. Brain 111:541–552
Podell DN, Packman CH, Maniloff J, Abraham GN (1987) Characterization of monoclonal IgG cryoglobulins: fine structural and morphological analysis. Blood 69:677–681
Schröder JM (1986) Proliferation of epineurial capillaries and smooth muscle cells in angiopathic peripheral neuropathy. Acta Neuropathol (Berl) 72:29–37
Siguier F, Godeau P, Levy R, Binet JL, Hamida B (1964) A propos d'un cas de cryoglobulinemie (étude clinique et biologique). Semin Hop Paris 40:1928–1934
Vallat JM, Desproges-Gotteron R, Leboutet MJ, Loubet A, Gualde N, Treves R (1980) Cryoglobulinemic neuropathy: a pathological study. Am Neurol 8:179–185
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Prior, R., Schober, R., Scharffetter, K. et al. Occlusive microangiopathy by immunoglobulin (IgM-kappa) precipitation: pathogenetic relevance in paraneoplastic cryoglobulinemic neuropathy. Acta Neuropathol 83, 423–426 (1992). https://doi.org/10.1007/BF00713536
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00713536