IgM型意义未明的单克隆丙种球蛋白病（IgM-MGUS）与IgG型意义未明的单克隆丙种球蛋白病（IgG-MGUS）所致多发性神经病的比较。
Comparison of IgM-MGUS and IgG-MGUS polyneuropathy.
作者信息
Simovic D, Gorson K C, Ropper A H
机构信息
Neurology Service, St Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA 02135, USA.
出版信息
Acta Neurol Scand. 1998 Mar;97(3):194-200. doi: 10.1111/j.1600-0404.1998.tb00636.x.
OBJECTIVE
To compare the clinical and electrodiagnostic features and response to treatment in patients with IgM-MGUS and IgG-MGUS associated polyneuropathy.
MATERIAL AND METHODS
Retrospective review of 34 consecutive patients with MGUS associated neuropathy evaluated over 5 years.
RESULTS
There were 19 patients with IgM-MGUS and 15 with IgG-MGUS. There were no differences in age, duration of symptoms, or distribution of motor and sensory symptoms or signs. IgM-MGUS patients had prolonged distal latencies of the median and ulnar motor potentials, greater slowing of the peroneal nerve conduction velocity and more often absent ulnar sensory potentials. Half of the patients in both groups improved following immunotherapy.
CONCLUSION
IgM-MGUS patients had more severe demyelination on the nerve conduction studies, but there were no clinical features that differentiated the 2 groups. IgM and IgG-MGUS patients improved with plasma exchange and other immune therapies. Anti-MAG antibodies failed to distinguish a subgroup of patients with IgM-MGUS neuropathy.
目的
比较IgM型意义未明的单克隆丙种球蛋白病（IgM-MGUS）和IgG型意义未明的单克隆丙种球蛋白病（IgG-MGUS）相关多发性神经病患者的临床和电诊断特征及治疗反应。
材料与方法
回顾性分析5年间连续评估的34例MGUS相关神经病患者。
结果
19例为IgM-MGUS患者，15例为IgG-MGUS患者。两组在年龄、症状持续时间、运动和感觉症状或体征分布方面无差异。IgM-MGUS患者正中神经和尺神经运动电位的远端潜伏期延长，腓总神经传导速度减慢更明显，尺神经感觉电位缺失更常见。两组中均有一半患者在免疫治疗后病情改善。
结论
神经传导研究显示IgM-MGUS患者的脱髓鞘更严重，但两组间无临床特征可资鉴别。IgM和IgG-MGUS患者经血浆置换和其他免疫治疗后病情改善。抗MAG抗体未能区分出IgM-MGUS神经病患者亚组。
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