Sensory neuropathy with monoclonal IgM binding to a trisulfated heparin disaccharide
- 30 December 2002
- journal article
- case report
- Published by Wiley in Muscle & Nerve
- Vol. 27 (2), 188-195
- https://doi.org/10.1002/mus.10301
Abstract
We studied clinical and serological features of five patients with polyneuropathy and serum immunoglobulin M (IgM) binding to the trisulfated disaccharide IdoA2S‐GlcNS‐6S (TS‐HDS), the most abundant disaccharide component of heparin oligosaccharides. The patients all had painful, predominantly sensory polyneuropathies. Sensory loss was distal and panmodal. Electrophysiological and pathological studies were consistent with axonal loss, especially of unmyelinated axons. Immunohistochemistry showed IgM and κ light chains deposited around the rim of intermediate‐sized veins in the perimysium and epineurium. Serum IgM binding to TS‐HDS was selective, present in high titer (>12,000), and limited to κ light chains. We conclude that TS‐HDS is a newly identified target carbohydrate antigen of some IgM M‐proteins. Monoclonal IgM binding to TS‐HDS is associated with a painful, predominantly sensory, polyneuropathy syndrome with axonal loss and deposition of IgM in veins. The role of IgM binding to TS‐HDS in the pathogenesis of the neuropathy remains to be determined. Muscle Nerve 27: 188–195, 2003Keywords
This publication has 33 references indexed in Scilit:
- Sequence Analysis of Heparan Sulfate Epitopes with Graded Affinities for Fibroblast Growth Factors 1 and 2Published by Elsevier BV ,2001
- Fibroblast growth factor-II gene therapy reverts the clinical course and the pathological signs of chronic experimental autoimmune encephalomyelitis in C57BL/6 miceGene Therapy, 2001
- Reversal of experimental diabetic neuropathy by VEGF gene transferJCI Insight, 2001
- Internalization of HIV-1 Tat Requires Cell Surface Heparan Sulfate ProteoglycansJournal of Biological Chemistry, 2001
- Serum antibodies to heparan sulfate glycosaminoglycans in Guillain–Barré syndrome and other demyelinating polyneuropathiesJournal of Neuroimmunology, 1998
- Polyneuropathies associated with high titre antisulphatide antibodies: characteristics of patients with and without serum monoclonal proteins.Journal of Neurology, Neurosurgery & Psychiatry, 1997
- Polymyositis with cytochrome oxidase negative muscle fibres. Early quadriceps weakness and poor response to immunosuppressive therapyBrain, 1997
- Treatable gait disorder and polyneuropathy associated with high titer serum IgM binding to antigens that copurify with myelin‐associated glycoproteinMuscle & Nerve, 1994
- Distinct Role of 2-O-, N-, and 6-O-Sulfate Groups of Heparin in the Formation of the Ternary Complex with Basic Fibroblast Growth Factor and Soluble FGF Receptor-1Biochemical and Biophysical Research Communications, 1994
- QUALITATIVE AND QUANTITATIVE MORPHOLOGY OF HUMAN SURAL NERVE AT DIFFERENT AGESBrain, 1985