Autoantibody-Mediated Sensory Polyneuropathy Associated with Indolent B-Cell Non-Hodgkin's Lymphoma: A Report of Two Cases.
10.3988/jcn.2015.11.3.283
- Author:
Joerg Patrick STUBGEN
1
Author Information
1. Department of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA. pstuebge@med.cornell.edu
- Publication Type:Case Report
- Keywords:
autoimmunity;
neuropathy;
non-Hodgkin's lymphoma
- MeSH:
Aged;
Antibodies;
Autoantibodies;
Autoimmunity;
B-Lymphocytes*;
Cost-Benefit Analysis;
Gangliosides;
Humans;
Immunoglobulin G;
Lymphoma;
Lymphoma, B-Cell;
Lymphoma, Non-Hodgkin*;
Peripheral Nervous System;
Polyneuropathies*
- From:Journal of Clinical Neurology
2015;11(3):283-286
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: Abnormalities of the peripheral nervous system occur in 5% of patients with lymphoma. Polyneuropathy has not been described in patients with mantle-cell and marginal-zone B-cell lymphomas. CASE REPORT: Two elderly patients with indolent non-Hodgkin's lymphoma developed a progressive sensory polyneuropathy that was associated with serum autoantibodies directed against asialosyl/sialosyl gangliosides and myelin-associated glycoprotein/sulfated glucuronyl paragloboside, respectively, which are peripheral-nerve antigens. The oligoclonal pattern of these antibodies hinted at a lymphoma-induced immune dysregulation. The neuropathy stabilized clinically during treatment with intravenous immunoglobulin G. B-cell lymphoma was managed with a "watchful waiting" approach. CONCLUSIONS: The concept of antigen-specific, immune-mediated neuropathy associated with slow-growing lymphoma of mature B-cells may be underrecognized. The principle of treating the illness underlying neuropathy may not be always indicated or necessary if risk-benefit and cost-benefit analyses are taken into account.
