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Patients with malignant dysglobulinemias frequently present with or develop a type of peripheral neuropathy. Can immunoglobulin deposition be a mechanism of nerve damage, and can its detection guide therapy? To find out, researchers conducted histopathologic studies of sural nerves from seven patients with Waldenström dysglobulinemia, myeloma, or lymphoma. They used immunohistochemical techniques at the light- and electron-microscopic levels, which they cross-referenced with clinical and electrodiagnostic data.
In all seven patients, the authors observed endoneural immunoglobulin deposits in association with marked axonal loss. They conclude that, in the setting of a malignant dysglobulinemia and an axonal peripheral neuropathy, endoneural d…