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Osteosclerotic myeloma and peripheral neuropathy

Department of Neurology (Drs. Kelly and Dyck), the Division of Hematology and Internal Medicine (Dr. Kyle), and the Division of Endocrinology, Metabolism. and Internal Medicine (Dr. Miles). Mayo Clinic and Mayo Foundation, Rochester, MN.

Sixteen cases of osteosclerotic myeloma and peripheral neuropathy (SM-PN) were reviewed. The neuropathy resembled chronic inflammatory-demyelinating polyneuropathy with predominantly motor disability, high CSF protein levels, and low motor nerve conduction velocities. Twelve of the 16 patients had detectable levels of monoclonal serum proteins, all with A light chains, but results of other laboratory studies were usually normal. Most of the patients also had organomegaly, endocrine abnormalities, or both. Treatment of solitary lesions with tumoricidal irradiation usually improved the neuropathy and reversed the nonneurologic abnormalities; chemotherapy for multiple osteosclerotic lesions was less helpful.

Address correspondence and reprint requests to Dr. Kelly, Department of Neurology, Tufts-New England Medical Center, 171 Harrison Avenue, Boston. MA 01776.

This investigation was supported in part by Peripheral Neuropathy Program Project Grant No. NS-14304 from NINCDS. Program Project Grant No. CA-16835 from NCI, Center Grant from MDA, and Mayo, Borchard, Upton, Toor. Herrick, and Callagher Funds.

Accepted for publication June 18, 1982.

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