Autoimmune reactions in patients with M-component and peripheral neuropathy

V Jønsson, H D Schrøder, W Trojaborg, T S Jensen, E Hippe, M Mørk Hansen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

A study of 17 patients with autoimmune axonal or demyelinating peripheral neuropathy in combination with M-component is described. The M-component was associated with MGUS (monoclonal gammopathy of undetermined significance) in 12 patients, CLL in one patient, Waldenström's disease in one patient, and myeloma in three patients. Immunohistological examination with direct and indirect fluorescence showed binding of antibodies to nerve structures of the same class and light chain as seen in the M-component. In five cases of IgM M-component, the demyelinating neuropathy was caused by binding of the IgM M-protein and complement C3b to myelin-associated glycoproteins (MAG). In 12 cases with axonal neuropathy, binding of IgG to the connective tissue of the peri- and endoneurium was found in 50% of cases, IgM in five cases, and IgD in one case. None of the patients had central nervous system (CNS) symptoms. The clinical and therapeutic difficulties are discussed; only two patients with an acute course responded to immunosuppression. A marked co-expression of other autoimmune phenomena is interpreted in the light of cross-reactions between the autoantibody and similar tissue autoantigens.

OriginalsprogEngelsk
TidsskriftJournal of Internal Medicine. Supplement
Vol/bind232
Udgave nummer2
Sider (fra-til)185-91
Antal sider7
ISSN0954-6820
StatusUdgivet - aug. 1992

Fingeraftryk

Myeloma Proteins
Peripheral Nervous System Diseases
Peripheral Nerves
Myelin-Associated Glycoprotein
Cross Reactions
Connective Tissue
Central Nervous System
Fluorescence

Citer dette

Jønsson, V., Schrøder, H. D., Trojaborg, W., Jensen, T. S., Hippe, E., & Mørk Hansen, M. (1992). Autoimmune reactions in patients with M-component and peripheral neuropathy. Journal of Internal Medicine. Supplement, 232(2), 185-91.
Jønsson, V ; Schrøder, H D ; Trojaborg, W ; Jensen, T S ; Hippe, E ; Mørk Hansen, M. / Autoimmune reactions in patients with M-component and peripheral neuropathy. I: Journal of Internal Medicine. Supplement. 1992 ; Bind 232, Nr. 2. s. 185-91.
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Jønsson, V, Schrøder, HD, Trojaborg, W, Jensen, TS, Hippe, E & Mørk Hansen, M 1992, 'Autoimmune reactions in patients with M-component and peripheral neuropathy', Journal of Internal Medicine. Supplement, bind 232, nr. 2, s. 185-91.

Autoimmune reactions in patients with M-component and peripheral neuropathy. / Jønsson, V; Schrøder, H D; Trojaborg, W; Jensen, T S; Hippe, E; Mørk Hansen, M.

I: Journal of Internal Medicine. Supplement, Bind 232, Nr. 2, 08.1992, s. 185-91.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Autoimmune reactions in patients with M-component and peripheral neuropathy

AU - Jønsson, V

AU - Schrøder, H D

AU - Trojaborg, W

AU - Jensen, T S

AU - Hippe, E

AU - Mørk Hansen, M

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N2 - A study of 17 patients with autoimmune axonal or demyelinating peripheral neuropathy in combination with M-component is described. The M-component was associated with MGUS (monoclonal gammopathy of undetermined significance) in 12 patients, CLL in one patient, Waldenström's disease in one patient, and myeloma in three patients. Immunohistological examination with direct and indirect fluorescence showed binding of antibodies to nerve structures of the same class and light chain as seen in the M-component. In five cases of IgM M-component, the demyelinating neuropathy was caused by binding of the IgM M-protein and complement C3b to myelin-associated glycoproteins (MAG). In 12 cases with axonal neuropathy, binding of IgG to the connective tissue of the peri- and endoneurium was found in 50% of cases, IgM in five cases, and IgD in one case. None of the patients had central nervous system (CNS) symptoms. The clinical and therapeutic difficulties are discussed; only two patients with an acute course responded to immunosuppression. A marked co-expression of other autoimmune phenomena is interpreted in the light of cross-reactions between the autoantibody and similar tissue autoantigens.

AB - A study of 17 patients with autoimmune axonal or demyelinating peripheral neuropathy in combination with M-component is described. The M-component was associated with MGUS (monoclonal gammopathy of undetermined significance) in 12 patients, CLL in one patient, Waldenström's disease in one patient, and myeloma in three patients. Immunohistological examination with direct and indirect fluorescence showed binding of antibodies to nerve structures of the same class and light chain as seen in the M-component. In five cases of IgM M-component, the demyelinating neuropathy was caused by binding of the IgM M-protein and complement C3b to myelin-associated glycoproteins (MAG). In 12 cases with axonal neuropathy, binding of IgG to the connective tissue of the peri- and endoneurium was found in 50% of cases, IgM in five cases, and IgD in one case. None of the patients had central nervous system (CNS) symptoms. The clinical and therapeutic difficulties are discussed; only two patients with an acute course responded to immunosuppression. A marked co-expression of other autoimmune phenomena is interpreted in the light of cross-reactions between the autoantibody and similar tissue autoantigens.

KW - Adult

KW - Autoantibodies

KW - Autoimmunity

KW - Blood Proteins

KW - Demyelinating Diseases

KW - Female

KW - Humans

KW - Immunoglobulins

KW - Male

KW - Middle Aged

KW - Treatment Outcome

KW - Case Reports

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Jønsson V, Schrøder HD, Trojaborg W, Jensen TS, Hippe E, Mørk Hansen M. Autoimmune reactions in patients with M-component and peripheral neuropathy. Journal of Internal Medicine. Supplement. 1992 aug;232(2):185-91.