polyneuropathy

A Case of M-Paraprotein-Associated Polyneuropathy with Stable Response to Rituximab Therapy

RARE HEMATOLOGICAL TUMORS AND SYNDROMES , , ,

VG Potapenko1,3, VN Kiselev2

1 Municipal Clinical Hospital No. 31, 3 Dinamo pr-t, Saint Petersburg, Russian Federation, 197110

2 AM Nikiforov Russian Center of Emergency and Radiation Medicine, 4/2 Akademika Lebedeva str., Saint Petersburg, Russian Federation, 194044

3 IP Pavlov First Saint Petersburg State Medical University, 6/8 L’va Tolstogo str., Saint Petersburg, Russian Federation, 197022

For correspondence: Vsevolod Gennad’evich Potapenko, 3 Dinamo pr-t, Saint Petersburg, Russian Federation, 197110; Tel.: +7(905)284-51-38; e-mail: potapenko.vsevolod@mail.ru

For citation: Potapenko VG, Kiselev VN. A Case of M-Paraprotein-Associated Polyneuropathy with Stable Response to Rituximab Therapy. Clinical oncohematology. 2019;12(4):434–7 (In Russ).

DOI: 10.21320/2500-2139-2019-12-4-434-437

ABSTRACT

Monoclonal gammopathy of undetermined significance is diagnosed on the basis of an extensive search for a diagnostic reason as paraprotein secretion occurs in different diseases. One of polyneuropathies associated with M-paraproteinemia is anti-MAG demyelinating polyneuropathy (AMDP). The first-line treatment of this disease is based on prednisolone, and intravenous immunoglobulin. The second-line therapy of treatment-resistant patients is not determined. We report a case of a female patient with AMDP who received prednisolone, azathioprine, and plasmapheresis; however, stable response was reached only after the use of rituximab.

Keywords: paraprotein, monoclonal gammopathy of undetermined significance (MGUS), myelin-associated glycoprotein (MAG), polyneuropathy, rituximab.

Received: January 22, 2019

Accepted: September 5, 2019

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Organizational principles of neurologist’s work in hematological in-patient clinic

CLINICAL PRESENTATION, DIAGNOSIS, AND MANAGEMENT OF LYMPHOID MALIGNANCIES , , ,

K.A. Panyushin, Yu.M. Potapkina, Ye.V. Ignatyeva, T.A. Moskovskaya, T.V. Zhbrykunova, and O.A. Rukavitsyn

N.N. Burdenko Principal Military Clinical Hospital, RF Ministry of Defense, Moscow, Russian Federation

ABSTRACT

37 patients with hematological disorders underwent complex neurological evaluation including examination by a neurologist and electroneuromyography (ENMG). It is found that the considerable portion (51.3 %) of hematological patients shows signs of polyneuropathy as early as at the time of diagnosis. The data obtained indicate the possible need in specific neurological treatment just at the time of the initial tumor diagnosis prior to chemotherapy. The doses of chemotherapeutic agents should also be discussed in order to decrease their adverse effect on the peripheral nervous system. The results obtained suggest that detection of any hematological disorder necessitates examination by a neurologist, and neurological monitoring in a hematological in-patient clinic is an important part of management of patients with hematological malignancies.

Keywords: lymphoproliferative diseases, polyneuropathy, ENMG, polychemotherapy

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