J Clin Neurol.  2015 Jul;11(3):283-286. 10.3988/jcn.2015.11.3.283.

Autoantibody-Mediated Sensory Polyneuropathy Associated with Indolent B-Cell Non-Hodgkin's Lymphoma: A Report of Two Cases

• Stubgen JP

• KMID: 1894571
• DOI: http://doi.org/10.3988/jcn.2015.11.3.283

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.

Keyword

autoimmunity; neuropathy; non-Hodgkin's lymphoma

MeSH Terms

Aged
Antibodies
Autoantibodies
Autoimmunity
B-Lymphocytes*
Cost-Benefit Analysis
Gangliosides
Humans
Immunoglobulin G
Lymphoma
Lymphoma, B-Cell
Lymphoma, Non-Hodgkin*
Peripheral Nervous System
Polyneuropathies*
Antibodies
Autoantibodies
Gangliosides
Immunoglobulin G

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