Neuromusclar Disorders and monoclonal gammopathies

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Neuromusclar Disorders and monoclonal gammopathies

Postby jro on December 8th, 2008, 9:28 pm

There doesn't seem to be much interest in this topic on the board but I thought I'd throw this recent article out there for comment. It is current (2008) and comes from the Mayo Clinic. The first line says this condition is uncovered in 10% of those with peripheral neuropathy complaints. Twitching and cramping are peripheral neuropathy complaints. I did not have this test ordered by the first two neuros I saw so it must not be a first-line test. The test is serum immunofixation and urine immunofixation. How many know if they've had this test? If you are interested in having it, maybe bringing in this article would help you make your case for it. I know it is scary because of its connection with the diseases mentioned but it is not a forgone conclusion that you will get one of these (75% never do). If you only have a small amount of the protein you may only have a 5% chance of ever developing these other diseases but can still have the neuropathy symptoms.
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Phys Med Rehabil Clin N Am. 2008 Feb;19(1):61-79, vi.Click here to read Links
Neuromuscular disorders associated with paraproteinemia.
Hoffman-Snyder C, Smith BE.

Department of Neurology, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA. [email protected]

Neuromuscular disorders associated with monoclonal gammopathies are usually uncovered in approximately 10% of patients presenting with peripheral neuropathy complaints. This discovery should prompt further evaluation for underlying plasma cell dyscrasias. The most frequent monoclonal disorders associated with neuropathy are smoldering myeloma, multiple myeloma, Waldenström macroglobulinemia, solitary plasmacytoma, systemic immunoglobulin light chain (AL) amyloidosis, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes), and cryoglobulinemia. If these are excluded by careful evaluation the patient is classified as having monoclonal gammopathy of undetermined significance. Diagnostic criteria, risk stratification to determine prognosis, and current management for these disorders are reviewed in this article.
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Neuromusclar Disorders and monoclonal gammopathies

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