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• Vol.53 No.10
• CLINICA NEUROL, 53: 799−802, 2013
• Vol.53 No.10 contents

Case Report

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

Haruko Nakamura, M.D.¹⁾²⁾, Masanao Endo, M.D.¹⁾, Eriko Sugawara, M.D.¹⁾, Motoi Kuwahara, M.D.³⁾, Susumu Kusunoki, M.D.³⁾, Fumiaki Tanaka, M.D.²⁾ and Tatsuya Takahashi, M.D.¹⁾

¹⁾Department of Neurology, National Hospital Organization Yokohama Medical Center
²⁾Department of Neurology, Yokohama City University Graduate School of Medicine
³⁾Department of Neurology, Kinki University School of Medicine

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.
Full Text of this Article in Japanese PDF (1251K)

(CLINICA NEUROL, 53: 799−802, 2013)
key words: IgM paraproteinemia, polyneuropathy, anti SGPG antibody

(Received: 18-Jan-13)