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• Vol.55 No.5
• CLINICA NEUROL, 55: 349−352, 2015
• Vol.55 No.5 contents

Brief Clinical Note

A case of sensory ataxic axonal polyneuropathy with IgGλ monoclonal gammopathy successfully treated with intravenous immunoglobulin therapy

Yoichi Kanatsuka, M.D.¹⁾²⁾, Osamu Hasegawa, M.D.³⁾, Ryoko Imazeki, M.D.¹⁾ and Masahiro Yamamoto, M.D.¹⁾

¹⁾Department of Neurology, Yokohama Brain and Spine Center
²⁾Department of Neurology, Yokohama Municipal Citizen's Hospital
³⁾Department of General Medicine, Yokohama City University Medical Center

We report the case of an 84-year-old man with sensory ataxic polyneuropathy and IgGλ monoclonal gammopathy of undetermined significance (MGUS), which was successfully treated with intravenous immunoglobulin (IVIG) therapy. He had developed progressive ataxic gait over the span of 2 years before he was admitted to our hospital. On admission, he was unable to walk without assistance because of severe sensory ataxia. He performed poorly on the finger-nose-finger and heel-knee tests, and his vibration and position sense in the feet was remarkably diminished. However, motor involvement was not remarkable. Serum immunoelectrophoresis revealed IgGλ monoclonal gammopathy, and MGUS was diagnosed. Nerve conduction studies revealed sensory-dominant axonal polyneuropathy. The patient was successfully treated with IVIG (400 mg/kg/day, for 5 days). He regained his capacity to walk independently after treatment, but his nerve conduction results remained unchanged. This sensory ataxia might be partially due to underlying cervical spondylotic myelopathy. To our knowledge, this is the first report in our country of the successful use of IVIG therapy to treat a patient with IgGλ monoclonal gammopathy and related sensory ataxic axonal polyneuropathy.
Full Text of this Article in Japanese PDF (319K)

(CLINICA NEUROL, 55: 349−352, 2015)
key words: monoclonal gammopathy of undetermined significance, intravenous immunoglobulin, sensory ataxic axonal neuropathy, IgGλ

(Received: 14-Apr-14)