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Cerebrospinal fluid monoclonal gammopathy in multiple myeloma and Waldenström's macroglobulinemia

Marshfield Clinic, Marshfield, WI.

Serum ratios of monoclonal immunoglobulin (Ig) to total protein, monoclonal immunoglobulin to albumin, CSF/serum Ig-albumin index, and CSF to serum monoclonal immunoglobulin were obtained in 21 patients with multiple myeloma and 2 with Waldenström's macroglobulinemia. Twelve patients (3 with CNS complications) showed CSF monoclonal proteins similar to their serum. CSF IgA levels above 10 mg/dl, IgG levels above 25 mg/dl, CSF-serum IgG ratios above 0.0034 and CSF-serum IgA ratios above 0.0051 were seen in patients with neurologic complications. Our preliminary data may signal early CNS involvement in multiple myeloma.

Address correspondence and reprint requests to Dr. Mansotia, Marshfield Clinic and Medical Foundation, 1000 North Oak Avenue, Marshfield, WI 54449.

Presented in part at the thirty-second annual meeting of the American Academy of Neurology, Washington, DC, April 1982.

Accepted for publication March 22, 1983.