A CONTROLLED-STUDY OF INTRAVENOUS IMMUNOGLOBULIN IN DEMYELINATING NEUROPATHY WITH IGM GAMMOPATHY

Eleven patients with demyelinating polyneuropathy associated with mono clonal IgM antibodies were randomized to receive IVIg or placebo, mont hly, for 3 months in a double-blind study. After a washout period, the y crossed over to the alternate therapy. Response was gauged by evalua ting muscle strength, sensation, and neuromuscular symptoms at baselin e, after 3 months, and at treatment's end. After IVIg therapy, the str ength improved in only 2 of 11 patients, by 28 and 38.5 points from ba seline, and declined after placebo. In 1 other patient, the sensory sc ore improved by 13 points. Antibody titers to MAG/SGPG or gangliosides did not appreciably change. We conclude that Mg has only a modest ben efit to not more than 18% of patients with IgM paraproteinemic demyeli nating neuropathy.