Zusammenfassung
Polyneuropathien manifestieren sich bei M. Waldenström, Plasmozytom, Kryoglobulinämie, primärer Amyloidose sowie bei monoklonaler Gammopathie unbekannter Signifikanz (MGUS). Die Manifestationsform der paraproteinämischen Polyneuropathien ist meist symmetrisch. Die Neuropathien können sowohl vom demyelinisierenden, gemischten als auch vom axonalen Typ sein, ohne Unterschied zwischen IgG- oder IgM-MGUS. Die Differenzialdiagnostik gegenüber chronisch demyelinisierenden entzündlichen Polyneuropathien (CIDP) ist schwierig. Pathogenetisch kommen verschiedene Mechanismen infrage. Die richtige diagnostische Einordnung kann im Einzelfall eine frühe Diagnose proliferativer Prozesse (Plasmozytom, osteosklerotisches Myelom) sowie auch die erfolgreiche Therapie ermöglichen. Dabei spielt die Neurophysiologie eine wichtige Rolle.
Abstract
Peripheral neuropathies are seen in association with Waldenström's disease, plasmocytoma, cryoglobulinaemia, primary amyloidosis as well as monoclonal gammopathy of unknown significance (MGUS). The clinical manifestation is usually distal symmetric. Morphologically these polyneuropathies are demyelinating, intermediate or axonal with no difference between IgG- and IgM-MGUS. The differentiation between MGUS and chronic inflammatory demyelinating polyneuropathies (CIDP) may be difficult. An early correct diagnosis of polyneuropathy can help to discover myeloproliferative disorders (plasmocytoma, osteosclerotic myeloma). Furthermore, it is a prerequisite for successful treatment. Clinical neurophysiology plays an important role in the differential diagnosis of paraproteinaemic polyneuropathies.
Key words
Amyloidosis - MGUS - Waldenström's disease - multiple myeloma - paraproteinaemia - plasmocytoma
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Prof. Dr. Detlef Claus
Klinik für Neurologie Klinische Neurophysiologie · Klinikum Darmstadt
Heidelberger Landstraße 379
64297 Darmstadt
Email: d.claus@t-online.de
