Latov N, Hays A P, Sherman W H
Department of Neurology, Columbia University College of Physicians and Surgeons, New York, New York.
Crit Rev Neurobiol. 1988;3(4):301-32.
Peripheral neuropathy has been associated with monoclonal gammopathy in patients with Waldenstrom's macroglobulinemia, myeloma, B-cell lymphoma, and nonmalignant plasma cell dyscrasia. The neuropathy in these patients is heterogeneous and may be demyelinating or axonal, and sensory-motor or pure motor. The cause of neuropathy in many patients is unknown, but there is increasing evidence that in some cases it may be caused by autoantibody activity of M-proteins that bind to peripheral nerve antigens. Significant advances have been made in characterizing the autoantibody activity of M-proteins and correlating antigenic specificity with the type of neuropathy present, in elucidating the effector mechanisms responsible for causing nerve injury, and in understanding the causes for the aberrant immune response. This article reviews the recent advances made in this field and discusses their implications for the clinical evaluation and management of patients with peripheral neuropathy and monoclonal gammopathy.
外周神经病变与华氏巨球蛋白血症、骨髓瘤、B细胞淋巴瘤及非恶性浆细胞异常增生患者的单克隆丙种球蛋白病相关。这些患者的神经病变具有异质性，可能是脱髓鞘性或轴索性的，也可能是感觉运动性或单纯运动性的。许多患者神经病变的病因尚不清楚，但越来越多的证据表明，在某些情况下，可能是与外周神经抗原结合的M蛋白的自身抗体活性所致。在表征M蛋白的自身抗体活性、将抗原特异性与存在的神经病变类型相关联、阐明导致神经损伤的效应机制以及理解异常免疫反应的原因方面均取得了重大进展。本文综述了该领域的最新进展，并讨论了它们对外周神经病变和单克隆丙种球蛋白病患者临床评估和管理的意义。
