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Analyzing Relationship Between Monoclonal Gammopathy of Undetermined Significance (MGUS) with Different Types of Neuropathy: An Observational Study

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Abstract

To analyze multiple variables, including immunoglobulin subtypes in patients with monoclonal gammopathy of undetermined significance (MGUS) and different types of neuropathy. This was a retrospective, single center study done in a tertiary care hospital in the United States. The data was collected for years 2001–2011. Inclusion criteria were the presence of MGUS and neuropathy. Exclusion criteria were the presence of other factors such as diabetes, vitamin B12 deficiency, alcoholism etc. which can cause neuropathy. Patients with IgM MGUS were compared with patients having Non-IgM MGUS. A total of 281 patients were analyzed in this study. The average age at the time of diagnosis of MGUS and neuropathy was 68 years. The most common type of neuropathy was sensorimotor peripheral neuropathy (46 %). The most common location of neuropathy was the lower extremities (68 %). Among our patients, 52 % had their neuropathy symptoms for 1–5 years before presenting to the clinic. When IgM MGUS was compared with Non-IgM MGUS, a statistically significant difference was found in terms of race (White vs. Others, OR 4.43, 95 % CI 2.13, 9.19, p < 0.001) and survival status (OR 1.98, 95 % CI 1.01, 3.90, p = 0.046). Patients with MGUS are prone to develop different types of neuropathies. Caucasians are more likely to have IgM MGUS as compared to other races. IgM MGUS is generally related to worse outcomes as compared to Non-IgM MGUS. Medical therapies, including gabapentin and pregabalin are effective treatments and the response rate can be as high as 80–90 % with these medications.

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References

  1. Rojas-Garcia R, Gallardo E, Illa I (2013) Paraproteinemic neuropathies. Presse Med (Paris, France: 1983) 42(6 Pt 2):e225–e234. doi:10.1016/j.lpm.2013.02.329

    Article  Google Scholar 

  2. Leger JM, Chassande B, Bombelli F, Viala K, Musset L, Neil J (2009) Polyneuropathy associated with monoclonal gammopathy: treatment perspectives. Bull Acad Natl Med 193(5):1099–1110 discussion 1110–1091

    PubMed  Google Scholar 

  3. Weiss BM, Minter A, Abadie J, Howard R, Ascencao J, Schechter GP, Kuehl M, Landgren O (2011) Patterns of monoclonal immunoglobulins and serum free light chains are significantly different in black compared to white monoclonal gammopathy of undetermined significance (MGUS) patients. Am J Hematol 86(6):475–478. doi:10.1002/ajh.22025

    Article  CAS  PubMed  Google Scholar 

  4. Gosselin S, Kyle RA, Dyck PJ (1991) Neuropathy associated with monoclonal gammopathies of undetermined significance. Ann Neurol 30(1):54–61. doi:10.1002/ana.410300111

    Article  CAS  PubMed  Google Scholar 

  5. Suarez GA, Kelly JJ Jr (1993) Polyneuropathy associated with monoclonal gammopathy of undetermined significance: further evidence that IgM-MGUS neuropathies are different than IgG-MGUS. Neurology 43(7):1304–1308

    Article  CAS  PubMed  Google Scholar 

  6. Magy L, Chassande B, Maisonobe T, Bouche P, Vallat JM, Leger JM (2003) Polyneuropathy associated with IgG/IgA monoclonal gammopathy: a clinical and electrophysiological study of 15 cases. Eur J Neurol: Off J Eur Fed Neurol Soc 10(6):677–685

    Article  CAS  Google Scholar 

  7. Vrethem M, Reiser N, Lauermann C, Svanborg E (2010) Polyneuropathy associated with IgM vs IgG monoclonal gammopathy: comparison between clinical and electrophysiological findings. Acta Neurol Scand 122(1):52–57. doi:10.1111/j.1600-0404.2009.01259.x

    Article  CAS  PubMed  Google Scholar 

  8. Simovic D, Gorson KC, Ropper AH (1998) Comparison of IgM-MGUS and IgG-MGUS polyneuropathy. Acta Neurol Scand 97(3):194–200

    Article  CAS  PubMed  Google Scholar 

  9. Goldfarb AR, Sander HW, Brannagan TH 3rd, Magda P, Latov N (2005) Characterization of neuropathies associated with elevated IgM serum levels. J Neurol Sci 228(2):155–160. doi:10.1016/j.jns.2004.11.047

    Article  CAS  PubMed  Google Scholar 

  10. Nobile-Orazio E (2013) Neuropathy and monoclonal gammopathy. Handb Clin Neurol 115:443–459. doi:10.1016/b978-0-444-52902-2.00025-4

    Article  PubMed  Google Scholar 

  11. Niermeijer JM, Fischer K, Eurelings M, Franssen H, Wokke JH, Notermans NC (2010) Prognosis of polyneuropathy due to IgM monoclonal gammopathy: a prospective cohort study. Neurology 74(5):406–412. doi:10.1212/WNL.0b013e3181ccc6b9

    Article  CAS  PubMed  Google Scholar 

  12. Ahlskog MC, Kumar N, Mauermann ML, Klein CJ (2012) IgM-monoclonal gammopathy neuropathy and tremor: a first epidemiologic case control study. Parkinsonism Relat Disord 18(6):748–752. doi:10.1016/j.parkreldis.2012.03.007

    Article  PubMed  PubMed Central  Google Scholar 

  13. Steingrimsdottir H, Haraldsdottir V, Olafsson I, Gudnason V, Ogmundsdottir HM (2007) Monoclonal gammopathy: natural history studied with a retrospective approach. Haematologica 92(8):1131–1134

    Article  PubMed  Google Scholar 

  14. Filosto M, Cotelli M, Todeschini A, Broglio L, Vielmi V, Rinaldi F, Gregorelli V, Benelle M, Padovani A (2012) Clinical spectrum and evolution of monoclonal gammopathy-associated neuropathy: an observational study. Neurol 18(6):378–384. doi:10.1097/NRL.0b013e31826a99e9

    Article  Google Scholar 

  15. Yeung KB, Thomas PK, King RH, Waddy H, Will RG, Hughes RA, Gregson NA, Leibowitz S (1991) The clinical spectrum of peripheral neuropathies associated with benign monoclonal IgM, IgG and IgA paraproteinaemia. Comparative clinical, immunological and nerve biopsy findings. J Neurol 238(7):383–391

    Article  CAS  PubMed  Google Scholar 

  16. Theaudin M, Lozeron P, Lacroix C, Chretien P, Ducot B, Denier C, Adams D (2011) Short and long-term effect of IVIg in demyelinating neuropathy associated with MGUS, experience of a monocentric study. Rev Neurol 167(12):897–904. doi:10.1016/j.neurol.2011.04.005

    Article  CAS  PubMed  Google Scholar 

  17. Lunn MP, Nobile-Orazio E (2012) Immunotherapy for IgM anti-myelin-associated glycoprotein paraprotein-associated peripheral neuropathies. Cochrane Database Syst Rev 5:CD002827. doi:10.1002/14651858.CD002827.pub3

    PubMed  Google Scholar 

  18. Koike M, Sugimoto K, Tusui M, Yahata Y (2012) Successful treatment with rituximab in two cases of IgM-monoclonal gammopathy of undetermined significance (MGUS) neuropathy. [Rinsho ketsueki] Jpn J Clin Hematol 53(4):450–454

    Google Scholar 

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Correspondence to Shahzaib Nabi.

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Nabi, S., Kahlon, P., Bozorgnia, F. et al. Analyzing Relationship Between Monoclonal Gammopathy of Undetermined Significance (MGUS) with Different Types of Neuropathy: An Observational Study. Indian J Hematol Blood Transfus 32, 186–192 (2016). https://doi.org/10.1007/s12288-015-0547-9

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