Expert Clinical Perspectives: Paraproteinemic neuropathies-Article

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The document discusses paraproteinemic neuropathies, where monoclonal gammopathies can be found in about 10% of patients with peripheral neuropathy. Physicians need to determine if the neuropathy is related to the gammopathy or coincidental. Testing includes serum protein electrophoresis (SPEP) and immunofixation, as well as measurement of free light chains and immunoglobulins. Different neuropathy types associated with gammopathies are discussed: AL amyloidosis, POEMS syndrome, DADS neuropathy, CANOMAD, and cryoglobulinemia. The text outlines diagnostic approaches, testing methods, and management strategies for each condition. It emphasizes collaboration between neurologists and hematologist/oncologists for evaluating and managing patients. The discussion also covers AL amyloidosis, POEMS syndrome, and DADS neuropathy in detail, including diagnostic criteria, neurodiagnostic evaluations, and treatment options. Additionally, CANOMAD/CANDA conditions and cryoglobulinemia associated with paraproteinemia are explained. The importance of a multidisciplinary approach and ongoing monitoring of patients with monoclonal gammopathy for progression to malignancy or AL amyloidosis is highlighted. The article concludes with key points and references for further reading.

Keywords

paraproteinemic neuropathies

monoclonal gammopathies

peripheral neuropathy

serum protein electrophoresis

immunofixation

AL amyloidosis

POEMS syndrome

DADS neuropathy

CANOMAD

cryoglobulinemia