Vallat J M, Leboutet M J, Jauberteau M O, Tabaraud F, Couratier P, Akani F
Department of Neurology, University Hospital, Limoges, France.
Muscle Nerve. 1994 Apr;17(4):378-80. doi: 10.1002/mus.880170403.
The so-called "widening of the myelin lamellae" are thought to be specific ultrastructural features of peripheral nerve myelin in patients with peripheral neuropathy associated with a monoclonal dysglobulinemia of IgM type and antiglycolipid activity. We report here a case of Guillain-Barré syndrome with no evidence of serum monoclonal dysglobulinemia, presenting the typical widenings of the myelin lamellae in small-diameter myelinated fibers from a sural nerve biopsy. In view of the positive reaction with anti-C3d complement on direct immunofluorescence, an immunological mechanism may be involved in the widenings of the myelin lamellae.
