A case of IgM paraproteinemic neuropathy associated with anti-sulfated glucuronic paragloboside (SGPG) IgG antibody without anti-myelin-associated glycoprotein (MAG) activity

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  • Nakamura Haruko
    Department of Neurology, National Hospital Organization Yokohama Medical Center Department of Neurology, Yokohama City University Graduate School of Medicine
  • Endo Masanao
    Department of Neurology, National Hospital Organization Yokohama Medical Center
  • Sugawara Eriko
    Department of Neurology, National Hospital Organization Yokohama Medical Center
  • Kuwahara Motoi
    Department of Neurology, Kinki University School of Medicine
  • Kusunoki Susumu
    Department of Neurology, Kinki University School of Medicine
  • Tanaka Fumiaki
    Department of Neurology, Yokohama City University Graduate School of Medicine
  • Takahashi Tatsuya
    Department of Neurology, National Hospital Organization Yokohama Medical Center

Bibliographic Information

Other Title
  • 抗SGPG IgG抗体陽性，抗MAG/SGPG IgM抗体陰性のIgM M蛋白血症にともなう多発ニューロパチーの1例
  • 症例報告 抗SGPG IgG抗体陽性,抗MAG/SGPG IgM抗体陰性のIgM M蛋白血症にともなう多発ニューロパチーの1例
  • ショウレイ ホウコク コウSGPG IgG コウタイ ヨウセイ,コウMAG/SGPG IgM コウタイ インセイ ノ IgM M タンパク ケツショウ ニ トモナウ タハツ ニューロパチー ノ 1レイ

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Description

We report a case of IgM paraproteinemic neuropathy associated with anti-sulfated glucuronic paragloboside (SGPG) IgG antibody. An 84-year old man complained of numbness on the left side of the face and in the distal portions of the limbs. Neurological examination showed mild sensory ataxia. The laboratory tests revealed the presence of IgM lambda paraproteinemia and anti-SGPG IgG antibody without anti-myelin-associated glycoprotein (MAG) activity and anti-MAG/SGPG IgM antibody. Results of nerve conduction study showed decreased sensory nerve action potential (SNAP) amplitude, indicating the presence of sensory-dominant axonal polyneuropathy, and the prolongation of distal latency was not observed. Treatment with corticosteroids resulted in a rapid improvement in neurological abnormalities. In IgM paraproteinemic neuropathy associated with anti-MAG/SGPG antibody, distal acquired demyelinating sensory neuropathy and resistance to immunological treatments are the characteristic pathologic and clinical features, respectively. On the other hand our rare case of IgM paraproteinemic neuropathy positive for anti-SGPG IgG antibody presented with axonal sensory polyneuropathy and a good responsiveness to corticosteroids.

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 53 (10), 799-802, 2013

    Societas Neurologica Japonica

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