Journal Article

Monoclonal Gammopathy–Associated Peripheral Neuropathy: Diagnosis and Management

Rajkumar, S. Vincent, Mauermann, Michelle L., Chaudhry, Hafsa M.

2017

Overview

Monoclonal gammopathies comprise a spectrum of clonal plasma cell disorders that include monoclonal gammopathy of undetermined significance, multiple myeloma, and Waldenström macroglobulinemia. In this review, we outline the epidemiology, etiology, classification, diagnosis, and treatment of monoclonal gammopathy–associated peripheral neuropathy. Monoclonal gammopathy of undetermined significance is relatively common in the general population, with a prevalence of 3% to 4% among individuals older than age 50 years. Therefore, the presence of M protein in a patient with neuropathy does not automatically indicate a causal relationship. Monoclonal gammopathy–associated peripheral neuropathy is often a difficult diagnosis with limited treatment options. Studies addressing the optimal approach to diagnosis and management of this entity are limited. In addition to a review of the literature, we present a diagnostic approach to patients with monoclonal gammopathy–associated peripheral neuropathy and discuss available data and options for treatment.

• Publisher: Elsevier Inc,Elsevier, Inc,Elsevier Limited
• Subject: Administration, Intravenous / Amyloidosis / Benign monoclonal gammopathy / Biomarkers - analysis / Care and treatment / Demyelinating Autoimmune Diseases, CNS - diagnosis / Demyelinating Autoimmune Diseases, CNS - epidemiology / Demyelinating Autoimmune Diseases, CNS - etiology / Demyelinating Autoimmune Diseases, CNS - immunology / Development and progression / Diagnosis / Diagnosis, Differential / Disease / Endocrine disorders / Epidemiology / Glycoproteins / Glycoproteins - adverse effects / Glycoproteins - analysis / Hematology / Humans / Immunoglobulins / Immunoglobulins - administration & dosage / Immunologic Factors - therapeutic use / Internal Medicine / Literature reviews / M protein / Macroglobulinemia / Medical diagnosis / Monoclonal antibodies / Monoclonal Gammopathy of Undetermined Significance - complications / Monoclonal Gammopathy of Undetermined Significance - epidemiology / Monoclonal Gammopathy of Undetermined Significance - immunology / Multiple myeloma / Myeloablative Agonists - therapeutic use / Neurology / Neurosciences / Patients / Peripheral Nervous System Diseases - diagnosis / Peripheral Nervous System Diseases - epidemiology / Peripheral Nervous System Diseases - etiology / Peripheral Nervous System Diseases - therapy / Peripheral neuropathy / Physiological aspects / Plasmapheresis - methods / Polyneuropathies / Polyneuropathy / Population / Prognosis / Proteins / Psychiatry / Risk factors / Rituximab - therapeutic use / Studies / Vidarabine - analogs & derivatives / Vidarabine - therapeutic use