Clinical and laboratory features of neuropathies with serum IgM binding to TS-HDS

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Abstract

Introduction: In this investigation we studied clinical and laboratory features of polyneuropathies in patients with serum IgM binding to the trisulfated disaccharide IdoA2S-GlcNS-6S (TS-HDS). Methods:: We retrospectively compared 58 patients with selective IgM binding to TS-HDS to 41 consecutive patients with polyneuropathies without TS-HDS binding. Results:: Patients with IgM vs. TS-HDS commonly had distal, sensory, axonal neuropathies. Weakness was associated with IgM M-proteins. Hand pain and serum IgM M-proteins were more common than in control neuropathy patients. TS-HDS antibody binding was often selectively κ class. Biopsies showed capillary pathology with thickened basal lamina and C5b9 complement deposition. IgM in sera with TS-HDS antibodies often bound to capillaries. Conclusions:: Serum IgM binding to TS-HDS is associated with painful, sensory > motor, polyneuropathies with an increased frequency of persistent hand discomfort, serum IgM M-proteins, and capillary pathology. Serum IgM binding to TS-HDS suggests a possible immune etiology underlying some otherwise idiopathic sensory polyneuropathies.

Original languageEnglish
Pages (from-to)866-872
Number of pages7
JournalMuscle and Nerve
Volume45
Issue number6
DOIs
StatePublished - Jun 2012

Keywords

  • Heparin disaccharide
  • IgM antibody
  • M-protein
  • Neuropathic
  • Pain
  • Sensory neuropathy

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