Neuroimmunology of Paraproteinemic Neuropathies
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Neuroimmunology of Paraproteinemic Neuropathies
A. A. Ilyas
1
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
2
Paraproteinemias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
3
Neuropathies Associated with Paraproteinemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
4 Neural Antigens for Paraproteins in Patients with Neuropathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232 4.1 Glycoprotein Antigens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232 4.2 Glycosphingolipid Antigens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232 5
Methods for Detecting Antibodies to Neural Antigens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
6 6.1 6.2 6.3 6.4
Reactivity of Neuropathy‐Associated IgM Paraproteins with Neural Antigens . . . . . . . . . . . . . . . . . 233 Demyelinating Neuropathy Associated with Anti‐MAG/SGPG IgM Paraproteins . . . . . . . . . . . . . . . . 234 Neuropathy Associated with Anti‐Ganglioside IgM Paraproteins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236 Neuropathy Associated with Anti‐Sulfatide IgM Paraproteins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236 Neuropathy Associated with IgM Paraproteins to Other Antigens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
7
Neuropathy Associated with Nonmalignant IgG and IgA Monoclonal Gammopathy . . . . . . . . . 237
8 8.1 8.2 8.3 8.4
Neuropathies Associated with Malignant Monoclonal Gammopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . 238 Neuropathy Associated with Waldenstrom’s Macroglobulinemia (WM) . . . . . . . . . . . . . . . . . . . . . . . . . 239 Neuropathy Associated with Multiple Myeloma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 Neuropathy Associated with Osteosclerotic Myeloma (POEMS Syndrome) . . . . . . . . . . . . . . . . . . . . . . 239 Neuropathy Associated with Cryoglobulinemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
9 9.1 9.2 9.3
Animal Models of Peripheral Neuropathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 Experimental Neuropathy Associated with Anti‐MAG/SGPG Antibodies . . . . . . . . . . . . . . . . . . . . . . . . 239 Experimental Neuropathies Induced by Antibodies to Gangliosides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240 Experimental Neuro
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