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Neuropathy and anti-MAG antibodies without detectable serum M-protein

From the Department of Neurology (Drs. Nobile-Orazio, Latov, Abrams, Miller, Messito, Saito, Tahmoush, Lovelace, and Rowland) Neuropathology (Drs. Hays and Takatsu), and Medicine (Dr. Sherman), Columbia University College of Physicians and Surgeons, New York.

Anti-MAG IgM antibodies were detected by ELISA in a patient with slowly progressive peripheral neuropathy. Serum IgM content was normal, and no M-protein was detected by serum protein electrophoresis, immunoelectrophoresis, or immunostaining. By immunoblot analysis, the anti-MAG antibodies were IgM_k; they reacted with human and bovine MAG but not with mouse MAG. The data suggest that there was an anti-MAG IgM M-protein in concentration too low to be detected by conventional techniques. Tests for anti-MAG antibodies should be done in patients with slowly progressive neuropathy of unknown etiology, even in the absence of detectable serum M-protein.

Address correspondence and reprint requests to Dr. Latov, Department of Neurology, Columbia University, College of Physicians and Surgeons, Black Bldg. Rm. 3.323, 630 West 168th Street, New York, NY 10032.

Supported by grants Nos. NS18016 and NS00659 from the NINCDS and by a grant from the Muscular Dystrophy Association. Dr. Nobile-Orazio is a visiting fellow from the Institute of Clinical Neurology, University of Milan, Italy, and is the recipient of the "De Visart" Award. Dr. M. Takatsu is a visiting fellow from Tokyo University, Japan, and is the recipient of a fellowship from the Muscular Dystrophy Association. Dr. T. Saito is a visiting fellow from Kitasato University, Japan.

Accepted for publication May 23, 1983.

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