A Rare Case of Polyneuropathy with an Underlying Paraprotienemic Origin

Dr. Perumalla Sai Lakshmi, Dr. N. V. Sundarachary, Dr. G. Bindu Narmada, Dr. M. Bhargavi Devi

Abstract: Introduction: Monoclonal gammopathies consist of a spectrum of clonal plasma cell disorders that includes Monoclonal Gammopathy of Undetermined Significance (MGUS), multiple myeloma (MM) and Waldenstrom Macroglobulinemia (WM). Peripheral neuropathy is a well-recognized complication of monoclonal gammopathies, and a difficult clinical problem in terms of diagnosis and treatment. Case Report: 54 year old male presented with symmetrical chronic progressive LMN type quadriparesis (distal> proximal) lower limb predominant with wasting, fasciculations, hypotonia and hyporeflexia, with both small and large fibre sensory involvement with skin changes with cachexia. Materials And Methods: We have done following investigations: CBC, RFT, LFT, serum electrolytes? within normal limits, NCS shown Bilateral severe sensori - motor demyelinating poly radiculoneuropathy with secondary axonal changes, CSF Analysis: TC-4 cells, DC-mostly lymphocytes; no RBC, Protein-144mg/dL, sugar-74mg/dL; Serum protein electrophoresis: non discrete protein band in gamma globulin region, possibly monoclonal gammopathy. Advised immunotyping which has shown Very faint? M spike in gamma globulin region of igG and kappa lane. Final Diagnosis: Paraproteinemic neuropathy- Monoclonal Gammopathy of undetermined significance (MGUS). Discussion: The most common presentation is a symmetrical sensorimotor polyneuropathy, one of three more common subtypes: 1) CIDP phenotype, 2) Distal acquired demyelinating symmetric (DADS) neuropathy, or 3. an axonal sensorimotor peripheral polyneuropathy. Conclusion: Approximately 10% of patients with idiopathic peripheral neuropathy have an associated monoclonal gammopathy. Patients undergoing evaluation for chronic peripheral neuropathy should be screened for the presence of a monoclonal protein (M protein).

Keywords: MGUS, Monoclonal Gammopathy of Undetermined Significance, MM-multiple myeloma, WM- Waldenstrom Macroglobulinemia, IVIG-Intravenous Immunoglobulin

How to Cite?: Dr. Perumalla Sai Lakshmi, Dr. N. V. Sundarachary, Dr. G. Bindu Narmada, Dr. M. Bhargavi Devi, "A Rare Case of Polyneuropathy with an Underlying Paraprotienemic Origin", Volume 14 Issue 11, November 2025, International Journal of Science and Research (IJSR), Pages: 292-294, https://www.ijsr.net/getabstract.php?paperid=MR251104144425, DOI: https://dx.doi.org/10.21275/MR251104144425