Ferrer S, Jiménez C
Servicio de Neurología, Hospital Militar, Santiago de Chile.
Rev Med Chil. 1994 Apr;122(4):448-53.
We review the concept fo Monoclonal Gammopathy emphasizing that the so called benign forms, with or without polyneuropathy can have an unpredictable evolution. Polyneuropathies associated to monoclonal gammopathy-IgM, IgG, IgA, Waldestrom's disease, Multiple myeloma, Osteosclerotic myeloma (POEMS), Amyloidosis and Cryoglobulinemias are reviewed. They generally are solely sensory, sensorimotor or rarely, solely motor. The importance of neuro-physiological studies and nerve biopsy is emphasized. For progressive forms, treatment with plasmapheresis, immunotherapy, corticoids or intravenous gammaglobulin is suggested.
我们回顾了单克隆丙种球蛋白病的概念,强调所谓的良性形式,无论有无多发性神经病,其病情发展都可能无法预测。本文还综述了与单克隆丙种球蛋白病相关的多发性神经病——IgM、IgG、IgA型、华氏巨球蛋白血症、多发性骨髓瘤、骨硬化性骨髓瘤(POEMS综合征)、淀粉样变性和冷球蛋白血症。这些多发性神经病通常仅为感觉性、感觉运动性,或很少见的仅为运动性。文中强调了神经生理学研究和神经活检的重要性。对于进行性形式的疾病,建议采用血浆置换、免疫疗法、皮质类固醇或静脉注射丙种球蛋白进行治疗。