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Immunocytochemical studies of human peripheral nerve with serum from patients with polyneuropathy and paraproteinemia

Departments of Neurology (Drs. Abrams, Latov, and Zimmerman), Pathology (Dr. Hays), and Medicine (Dr. Sherman), College of Physicians and Surgeons, and H. Houston Merritt Clinical Research Center for Muscular Dystrophy and Related Diseases (Drs. Latov and Hays), Columbia University, New York, NY.

Immunohistochemical binding of IgM paraproteins to nerve was studied using the immunoperoxidase technique with serum from 10 patients with benign plasma cell dyscrasia and neuropathy. We stained the myelin sheaths of peripheral nerves and roots of five patients who had myelin-absorbable IgM paraproteins. Two patients with IgM paraproteins that did not react with myelin showed predominant staining of axons, while three were completely negative. Serum specimens from normal volunteers and patients with paraproteinemias or ALS were also unreactive. Immunocytochemical methods can detect IgM paraproteins with an affinity for nerve antigens and may assist in the diagnosis and classification of plasma cell dyscrasia associated neuropathy.

Address correspondence and reprint requests to Dr. Abrams, Department of Neurology, Columbia University, 650 West 168th Street, New York, NY 10032.

This work was supported by a grant from the Muscular Dystrophy Association and a grant (NIH RR00645) from the National Institutes of Health. Dr. Abrams is the recipient of Teacher-Investigator Development Award No. NS00478.

Presented in part at the thirty-third Annual Meeting of the American Academy of Neurology, Toronto, Canada, April 1981.

Accepted for publication January 7, 1982.

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