POLYNEUROPATHY IN MONOCLONAL GAMMOPATHY O F UNDETERMINED SIGNIFICANCE(MGUS) - INITIAL MANIFESTATION OF A LYMPHOMA

Background: Monoclonal gammopathics - including so-called monoclonal g ammopathies of undetermined significance - MGUS - may cause polyneurop athies, even if immunoglobulin concentrations are within a normal rang e. Case Report: We report on a patient with a rapidly progressive poly neuropathy with severe motor disturbances in whom a small amount of a monoclonal ISM kappa cryoglobulin was found. Only by extensive, repeat edly performed diagnostic procedures could scattered lymphoma cells be detected. Nonspecific immunosuppression had been unsuccessfull but ev entually a more specific chemotherapy led to an almost complete, susta ined recovery. Conclusion: This case shows that in patients with a pol yneuropathy of uncertain etiology monoclonal immunoglobulins should be looked for and that a MGUS can precede a lymphoma. Therefore these pa tients with a despite conventional immunosuppressive treatment should undergo large-scale that the chance for an adequate chemotherapy is ta ken.