Neurológia pre prax 1/2016

Paraproteinaemic neuropathies

There is a wide range of different types of neuropathies that are associated with abnormal immunoglobulin production. They are referred to as paraproteinaemic or dysproteinaemic neuropathies. Paraproteinaemia is a heterogeneous disease in which monoclonal gammopathy can essentially represent a benign process referred to as monoclonal gammopathy of undetermined significance (MGUS). On the other hand, monoclonal gammopathy can point out to the presence of a systemic haematological malignancy. The main diagnoses often linked with peripheral neuropathy include: Waldenström's macroglobulinaemia (WM), POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes), multiple myeloma (MM), and primary amyloidosis (AL). The article presents pathophysiological, clinical, electrophysiological, and therapeutic characteristics of neuropathic syndromes associated with the presence of paraprotein.

Keywords: monoclonal gammopathy, paraprotein, neuropathy, POEMS, myeloma, amyloid