Abstract:
A 51-year-old man with the chief complaint of glove- and stocking-type dysesthesia for >3 years was diagnosed with Waldenström\'s macroglobulinemia (WM) based on IgM-type M-proteinemia, bone marrow infiltration of plasmacytoid B cells, multiple lymphadenopathies, and splenomegaly. A nerve conduction examination suggested demyelinating neuropathy. Serum anti-myelin-associated glycoprotein antibody was negative. Sural nerve biopsy showed myelin thinning, suggesting demyelination. Axonal damage and tumor cell infiltration in the intrafascicular epineurium were also observed. After chemotherapies with rituximab and bendamustine, M-proteinemia and lymphadenopathies disappeared. However, abnormalities in the nerve conduction examination and dysesthesia were only slightly alleviated. As articles describing patients with WM with peripheral nerve infiltration are limited, we report this case with a literature review.
摘要:
根据IgM型M蛋白血症,一名51岁的男子以手套和放养型感觉障碍为主要主诉3年以上,被诊断为Waldenström巨球蛋白血症(WM),浆细胞样B细胞的骨髓浸润,多发性淋巴结病,脾肿大.神经传导检查提示脱髓鞘性神经病。血清抗髓鞘相关糖蛋白抗体阴性。腓肠神经活检显示髓鞘变薄,提示脱髓鞘.还观察到了束内神经外膜的轴突损伤和肿瘤细胞浸润。利妥昔单抗和苯达莫司汀化疗后,M蛋白血症和淋巴结病消失。然而,神经传导检查和感觉异常仅略有缓解。由于描述WM伴周围神经浸润患者的文章有限,我们对该病例进行文献复习。