Paraneoplastic painful ulnar neuropathy

A 58-year-old woman developed painful, bilateral ulnar neuropathy in conjun ction with small cell lung carcinoma and high serum titer of anti-l-lu anti body. An incidental stage I plasma cell dyscrasia, with immunoglobulin G ka ppa monoclonal protein, was also present. Electropysiological assessment ex cluded a generalized neuropathy, and nerve biopsy showed marked loss of mye linated and small unmyelinated fibers, without inflammatory changes or amyl oid deposition. High titers of circulating anti-Hu antibody can be associat ed with symptoms resembling a paraneoplastic mononeuropathy. (C) 1999 John Wiley & Sons, Inc.