Benign monoclonal gammopathy and peripheral neuropathy

Abstract

Peripheral neuropathy has been described in malignant plasma cell dyscrasias such as multiple myeloma and Waldenstroem''s macroglobulinemia. Since it is not known whether the neuropathy is related to the plasma cell disorder or is a paramalignant phenomenon, 21 consecutive out-patients with benign monoclonal gammopathy (BMG) were analyzed for peripheral neuropathies. Eleven patients had noticed slight motor and/or sensory extremity symptoms. Clinical examination, electromyographic and electroneurographic studies of the upper and lower extremities were performed. In 5 patients all results indicated a neuropathy, 6 other patients had clinical signs of neuropathy and 4 additional patients had positive electromyographic and/or electroneurographic results. A total of 15 patients had clinical and/or electrophysiological results compatible with neuropathy. There were no significant differences in hematological parameters between the group in which all results indicated a neuropathy and the totally negative group, or between the 2 groups with and without clinical neuropathy. The benign form of plasma cell dyscrasias seems also to be associated with mild clinical or subclinical peripheral neuropathy.