The Clinical Features of Neuropathies Associated with Monoclonal Gammopathies (P7.085)

Background:Monoclonal Gammopathy (MG) is found in up to 10[percnt] of cryptogenic neuropathy patients. Paraproteinemic neuropathies (PPN) are mostly associated with monoclonal gammopathy of unknown significance (MGUS).Objectives:Characterizing different types of neuropathies associated with monoclonal gammopathies.Methods:This is a retrospective chart review of 34 patients seen in UAMS Neurology Clinic between 2009 and 2013. We included neuropathic patients with MG who were over the age of 18 years old. We excluded patients with uncontrolled diabetes mellitus, chronic inflammatory diseases, malignant tumors, previous history of chemotherapy and radiation therapy, history of alcohol abuse for 2 consecutive years and family history of hereditary sensorimotor neuropathies.Results:Thirty-four patients were included, 21 males and 13 females. The mean age of onset of neuropathy was 66.5 years. Twenty-six patients (76.5[percnt]) had MGUS, and 8 patients (23.5[percnt]) had hematological malignancies. The most frequent M-protein isotype associated with PPN was IgG (52.9[percnt]), followed by IgM (23.5[percnt]), IgA (11.8[percnt]), and light chain (11.8[percnt]). Serum electrophoresis was abnormal in 82.4[percnt] of patients, immunofixation was abnormal in 88.2[percnt] and free light chain was abnormal in 91.2[percnt]. Most patients (38.2[percnt]) presented with sensory neuropathy, (35.3[percnt]) with small fiber neuropathy and (26.5[percnt]) with sensorimotor neuropathy. The most frequent clinical symptom was sensory loss (91.1[percnt]), followed by painful paresthesias (85.3[percnt]), ataxia (35.3[percnt]), dysautonomia (29.4[percnt]) and weakness (20.6[percnt]).Sensory neuropathy was more common with IgG M-protein (61.5[percnt]; p= 0.4965). Sensory loss was more common with IgG M-protein (51.7[percnt]; p= 0.0747)Conclusion:MGUS is defined by the lack of end-organ damage. PPN may be significant due to the associated morbidity. Our study did not show significant correlation between clinical features of PPN and the underlying hematologic condition. Further studies are needed to define any correlation of PPN with specific paraproteinemia and the impact on neuropathy outcome and prognosis. Disclosure: Dr. Herlopian has nothing to disclose. Dr. Al-salaimeh has nothing to disclose. Dr. Gundogdu has nothing to disclose. Dr. Al-Lahham has nothing to disclose.