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Electrophysiologic study of experimental demyelination induced by serum of patients with IgM M proteins and neuropathy

From the Departments of Neurology (Drs. Trojaborg, Galassi, Lovelace, and Latov) and Pathology (Division of Neuropathology) (Dr. Hays and Ms. Alkaitis), College of Physicians and Surgeons, Columbia University, New York, NY.

We induced progressive conduction block in feline sciatic nerve by endoneurial injection of serum from 2 patients with demyelinating neuropathy and an anti-myelin-associated glycoprotein (MAG) IgM M protein. The block was long-lasting (up to 4 days) and affected about half the motor nerve fibers. Control serum from patients with an IgM M protein that did not react with MAG produced a transient block (<48 hours) that affected an average of 25% of motor fibers. Nerves with sustained block showed widespread demyelination of many nerve fibers, exceeding controls. The findings support the view that chronic demyelinating neuropathy in these patients is caused by the anti-MAG M protein.

Address correspondence and reprint requests to Dr. Hays, Division of Neuropathology, College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032.

Supported by a Center Grant from the Muscular Dystrophy Association.

Received February 28, 1989. Accepted for publication in final form June 1, 1989.

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