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首页> 外文期刊>Journal of neurology >Comparison of monoclonal gammopathy of undetermined significance-associated neuropathy and chronic inflammatory demyelinating polyneuropathy patients
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Comparison of monoclonal gammopathy of undetermined significance-associated neuropathy and chronic inflammatory demyelinating polyneuropathy patients

机译：不确定意义相关神经病和慢性炎症性脱髓鞘性多发性神经病的单克隆丙种球蛋白病的比较

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Objectives: There are varying reports on whether monoclonal gammopathy of undetermined significance-associated neuropathy (MGUSN) patients are distinguishable from those with chronic inflammatory demyelinating polyneuropathy (CIDP) and whether specific MGUSN subclasses are associated with specific clinical phenotypes. Methods: We performed a retrospective chart review of MGUSN (n = 56) and CIDP (n = 67) patients. Data extracted included: demographics, neurological examination, and nerve conduction studies (NCS) at baseline and last visit. Clinical status was rated as 0 = worse, 1 = unchanged, 2 = stabilized after a declining course, or 3 = improved. The electrophysiology data were rated as 0 = worse, 1 = stable, or 2 = improved. Statistical analyses were performed using JMP (version 9.0.2 for Macintosh, from SAS). Results: Seventy percent were males, aged 68.1 ?12.6 years with neuropathy for 9.8 ?6.8 years and follow-up of 4.0 ?3.2 years. CIDP patients had more severe neuropathy, and were more likely to receive treatment and to respond. The clinical neuropathy status remained unchanged in 52.8 % of the MGUSN and 24.2 % of the CIDP patients, and stabilized in 7.6 % of MGUSN and 30.3 % of CIDP patients. IgM-MGUSN patients did not differ from other immunoglobulin subclasses in response to treatment. The clinical severity and the number of abnormal NCS parameters were greater in the demyelinating MGUSN in comparison to the axonal group. Conclusion: MGUSN patients have less severe neuropathy than CIDP patients, but among the MGUSN patients the severity is greater in the demyelinating and the IgM groups. MGUSN patients may do well without treatment and exposure to potential adverse effects.
机译：目的：关于不确定性显着相关神经病（MGUSN）患者的单克隆丙种球蛋白病是否与慢性炎性脱髓鞘性多发性神经病（CIDP）患者有所区别，以及特定的MGUSN亚类是否与特定的临床表型相关，有不同的报道。方法：我们对MGUSN（n = 56）和CIDP（n = 67）患者进行了回顾性图表审查。提取的数据包括：基线和最后访视时的人口统计学，神经系统检查和神经传导研究（NCS）。临床状态被评定为0 =较差，1 =不变，2 =病程下降后稳定，或3 =改善。电生理数据的等级为0 =较差，1 =稳定或2 =改善。使用JMP（Macintosh的9.0.2版，来自SAS）进行统计分析。结果：男性占70％，年龄68.1-12.6岁，神经病9.8-6.8年，随访4.0-3.2年。 CIDP患者有更严重的神经病，并且更有可能接受治疗并做出反应。 MGUSN的52.8％和CIDP患者的24.2％的临床神经病状态保持不变，MGUSN的7.6％和CIDP患者的30.3％稳定。 IgM-MGUSN患者对治疗的反应与其他免疫球蛋白亚类没有区别。与轴突组相比，脱髓鞘性MGUSN的临床严重性和NCS参数异常的数量更大。结论：MGUSN患者的神经病变较CIDP患者轻，但在MGUSN患者中，脱髓鞘和IgM组的严重程度更高。 MGUSN患者可能会在不进行治疗且未暴露于潜在不良影响的情况下表现良好。

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