THE SIGNIFICANCE OF PARAPROTEINAEMIA IN PATIENTS WITH PRIMARY NEUROLOGICAL SYMPTOMS

Abstract

The diagnosis of paraproteinemia was made by immuno-electrophoretic examination of the serum in a material of 13 neurological patients, in only one of whom the diagnosis of myelomatosis had been made previously from the clinico-histological picture. In 8 cases there was concurrence between the immuno-electrophoretic findings and the clinical diagnosis of myelomatosis or Waldenstrom''s macroglobulinemia, when the clinical diagnosis had been reached by classical means. The possible diagnoses of the remaining 5 cases, in which there was a discrepancy between the immuno-electrophoretic diagnosis and the clinico-histological picture, are discussed with reference to the literature. The clinical-neurological picture in these diseases is extremely polymorphic, a fact confirmed by a review of the literature, and it is not possible to present any typical neurological findings. It is, however, noteworthy that 4 of the 13 cases pre- sented with paraplegia. Although the diseases of myelomatosis and Waldenstrom''s macroglobulinia are characterized by definite alterations in protein which can be demonstrated by immuno-electrophoresis one must-as long as our knowledge of preclinical paraproteinemia is so limited-continue to require that the diagnoses of myelomatosis and plasmacytoma and of Waldenstrom''s macroglobulinemia always be confirmed histologically.