Moth Henriksen Marie, Kolmos Eva Brøsted, Abildgaard Niels, Schrøder Henrik Daa, Sindrup Søren
Neurologisk Afdeling, Odense Universitetshospital.
Ugeskr Laeger. 2012 Oct 22;174(43):2630-4.
The prevalence of polyneuropathy in patients with monoclonal gammopathy of undetermined significance (MGUS) has been reported to be 10-50%. The majority of patients have a chronic, slowly progressive, distal, symmetric and predominantly sensory polyneuropathy. A caused relationship between polyneuropathy and immunoglobulin (Ig)M MGUS is better established than the relationship between polyneuropathy and IgG/IgA MGUS because of the observed binding of IgM to myelin sheaths and widening of myelin lamellae. In randomized controlled trials plasma exchange, immunosuppressive, rituximab and intravenous Ig have been found to have a clinical meaningful effect.
意义未明的单克隆丙种球蛋白病(MGUS)患者中多神经病的患病率据报道为10%-50%。大多数患者患有慢性、进展缓慢、远端、对称性且主要为感觉性的多神经病。由于观察到IgM与髓鞘结合以及髓鞘板层增宽,多神经病与免疫球蛋白(Ig)M MGUS之间的因果关系比多神经病与IgG/IgA MGUS之间的关系更明确。在随机对照试验中,已发现血浆置换、免疫抑制、利妥昔单抗和静脉注射免疫球蛋白具有临床意义的疗效。