Article

Immunostaining of skin biopsy adds no diagnostic value in MGUS-associated peripheral neuropathy

Journal of the Neurological Sciences, Elsevier, ISSN 0022-510X

Volume 349, 1-2, 2015

DOI:10.1016/j.jns.2014.12.026, Dimensions: pub.1038228685, PMID: 25582978,

Authors

* Corresponding author

Affiliations

Organisations

  1. (1) Odense University Hospital, grid.7143.1, Southern Denmark Region
  2. (2) Vejle Sygehus, grid.417271.6, Southern Denmark Region

Countries

Denmark

Continents

Europe

Description

BACKGROUND AND PURPOSE: For several decades an association between MGUS, IgM-MGUS in particular, and peripheral neuropathy has been suspected. Several histopathology studies have shown binding of IgM to myelin and a secondary widening of myelin lamellae in cutaneous nerves and in the sural nerve of patients with IgM-MGUS, or Waldenström's Macroglobulinaemia (WM), and peripheral neuropathy. In this retrospective study we investigated the value of skin biopsy examination in the diagnosis of MGUS- and WM-associated peripheral neuropathy. METHODS: A total of 117 patients, who were examined for an M-component in serum with associated nerve symptoms, had a skin biopsy taken and examined for immunoglobulin deposition in cutaneous nerves. Thirty-five patients were diagnosed with MGUS or WM and peripheral neuropathy with no other cause of neuropathy. Nineteen patients had MGUS but no peripheral neuropathy. RESULTS: Of the 35 patients with MGUS or WM and peripheral neuropathy, four had immunoglobulin deposition in the skin biopsy, all of whom had an IgM gammopathy. In the control group of 19 without peripheral neuropathy, three had immunoglobulin deposition in the skin biopsy, all of whom had IgM-MGUS. In both groups, there was a trend towards higher IgM blood levels in patients with immunoglobulin deposition. Half of the patients with IgM gammopathy in the neuropathy group had anti-MAG reactivity, whereas only one in the control group had weak anti-MAG reactivity. CONCLUSION: Our study indicates that examination of skin biopsies for immunoglobulin deposition does not add significant diagnostic value in the evaluation of neuropathies suspected to be caused by MGUS or WM. IgM immunoglobulin deposition in skin biopsy might merely be an epiphenomenon secondary to high IgM blood levels.

Research Categories

Main Subject Area

Fields of Research

Links & Metrics

NORA University Profiles

University of Southern Denmark

Danish Open Access Indicator

2014; 2015: Unused

Research area: Medicine

Danish Bibliometrics Indicator

2015: Level 1

Research area: Medicine

Dimensions Citation Indicators

Times Cited: 1

Field Citation Ratio (FCR): 0.23

Relative Citation ratio (RCR): 0.11