HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME: Take the course for this article: Volume 56, Number 2, January 23, 2001 Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Eurelings, M. Articles by Van den Berg, L.H. Search for Related Content PubMed PubMed Citation Articles by Eurelings, M. Articles by Van den Berg, L.H. Related Collections Diagnostic test assessment All Immunology Autoimmune diseases All Neuromuscular Disease Peripheral neuropathy

Neuropathy and IgM M-proteins

Prognostic value of antibodies to MAG, SGPG, and sulfatide

From the Department of Neurology, Rudolf Magnus Institute of Neuroscience (Drs. Eurelings, Notermans, Sasker, Wokke, and Van den Berg); Julius Center for Patient Oriented Research, University Medical Center Utrecht (Dr. Moons); Department of Neurology, University Hospital Groningen (Dr. De Jager); and Leiden University Medical Center (Dr. Wintzen), the Netherlands.

Address correspondence and reprint requests to Dr. L.H. Van den Berg, Department of Neurology, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; e-mail: l.h.vandenberg{at}neuro.azu.nl

BACKGROUND: In polyneuropathy associated with immunoglobulin M (IgM) monoclonal gammopathy, antibodies to myelin-associated glycoprotein (MAG), sulfoglucuronyl paragloboside (SGPG), and sulfatide have been associated with specific clinical and electrophysiologic features. However, it is not known whether the results of antibody tests provide additional information for the individual patient (and the neurologist) in terms of future neurologic deficit or outcome.

OBJECTIVE: To study the independent contribution of potential prognostic factors to the prediction of outcome of neuropathy associated with IgM monoclonal gammopathy.

METHODS: In accordance with the chronology in which prognostic factors are available in clinical practice, the association between prognostic factors and outcome was evaluated by univariate and multivariate logistic regression analysis in 65 patients with polyneuropathy and IgM monoclonal gammopathy.

RESULTS: In univariate analysis, the initial symptoms, the IgM light chain type, electrophysiologic and pathologic studies, the presence of sural nerve IgM deposition, and anti-MAG or anti-SGPG antibodies were significantly associated with outcome. However, multivariate analysis showed that only initial symptoms and electrophysiologic studies are independent prognostic factors: initial sensory symptoms of the feet are prognostic for a slowly progressive disease course and less disability at 4 years, and evidence for demyelination on electrophysiologic examination is prognostic for development of weakness and symptoms of the upper extremities at 4 years. Addition of anti-MAG or anti-SGPG antibody tests did not yield any additional prediction of outcome.

CONCLUSION: These results indicate that in clinical practice, antibody tests in polyneuropathy associated with IgM monoclonal gammopathy do not have a prognostic value in terms of future neurologic deficit or outcome.

This article has been cited by other articles:

				K. Townson, K. N Greenshields, J. Veitch, D. Nicholl, M. Eckhardt, O. Galanina, N. Bovin, E. Samain, T. Antoine, D. Bundle, et al. Sulfatide binding properties of murine and human antiganglioside antibodies Glycobiology, November 1, 2007; 17(11): 1156 - 1166. [Abstract] [Full Text] [PDF]

				Neuropathy and Antibodies to MAG, SGPG, and Sulfatide Journal Watch Neurology, March 28, 2001; 2001(328): 3 - 3. [Full Text]