Y. Mitsui et al., Sensorimotor polyneuropathy associated with chronic lymphocytic leukemia, IgM antigangliosides antibody and human T-cell leukemia virus I infection, MUSCLE NERV, 22(10), 1999, pp. 1461-1465
A 65-year-old man presented with a sensorimotor polyneuropathy associated w
ith B-cell chronic lymphocytic leukemia (CLL) and immunoglobulin M (IgM) an
tibody to various gangliosides. Etectrophysiological studies denoted signif
icant abnormalities of motor and sensory nerve conduction. Although the pat
hology of sural nerve biopsy looked minimally affected, immunohistochemical
studies showed specific binding of IgM to the human peripheral nerve. Our
patient also had high titer of antibody to human T-cell leukemia virus I (H
TLV-I) in both serum and cerebrospinal fluid (CSF), which might activate B-
cell-mediated immunity and facilitate the production of IgM antibody. The o
ther unique feature is the reactivity of antibody to gangliosides. The pati
ent had IgM antibody reactivities to gangliosides with disialosyl residue s
uch as GT1b, GQ1b and GD3, but not to GD1b. IgM antibody to gangliosides wi
th disialosyl residue has been reported in ataxic symptoms, but our patient
failed to demonstrate ataxia. Without reactivity to GD1b, sensory ataxic n
europathy might not develop even in the presence of antibody reactive to ot
her gangliosides with disialosyl residue. (C) 1999 John Wiley & Sons, Inc.