Objective - To compare the clinical and electrodiagnostic features and
response to treatment in patients with IgM-MGUS and IgG-MGUS associat
ed polyneuropathy. Material and methods - Retrospective review of 34 c
onsecutive patients with MGUS associated neuropathy evaluated over 5 y
ears. Results - There were 19 patients with IgM-MGUS and 15 with IgG-M
GUS, There were no differences in age, duration of symptoms, or distri
bution of motor and sensory symptoms or signs. IgM-MGUS patients had p
rolonged distal latencies of the median and ulnar motor potentials, gr
eater slowing of the peroneal nerve conduction velocity and more often
absent ulnar sensory potentials. Half of the patients in both groups
improved following immunotherapy. Conclusion - IgM-MGUS patients had m
ore severe demyelination on the nerve conduction studies, but there we
re no clinical features that differentiated the 2 groups. IgM and IgG-
MGUS patients improved with plasma exchange and other immune therapies
Anti-MAG antibodies failed to distinguish a subgroup of patients with
IgM-MGUS neuropathy.