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NEUROLOGY 1993;43:2202
© 1993 American Academy of Neurology

Presentation and initial clinical course in patients with chronic inflammatory demyelinating polyradiculoneuropathy

Comparison of patients without and with monoclonal gammopathy

Zachary Simmons, MD, James W. Albers, MD, PhD, Mark B. Bromberg, MD, PhD and Eva L. Feldman, MD, PhD

Division of Neurology (Dr Simmons), The Pennsylvania State University College of Medicine, Hershey, PA; and the Department of Neurology (Drs Albers, Bromberg, and Feldman), The University of Michigan Medical Center, Ann Arbor, MI.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) may occur in association with a monoclonal gammopathy of undetermined significance (MGUS) or a variety of other systemic illnesses. It is not known if the clinical features of CIDP are altered by the presence of an MGUS. We compared demographic features, clinical presentation, improvement and outcome after initial treatment, and electrodiagnostic features of a group of 77 patients with idiopathic CIDP (CIDP-I, no associated systemic illness) with 26 patients with CIDP in whom an MGUS was found during evaluation of the neuropathy (CIDP-MGUS). Patients with CIDP-MGUS had, on average, a more indolent course and less severe weakness than patients with CIDP-I, despite similar motor conduction studies. CIDP-MGUS patients also demonstrated less functional impairment, more frequent sensory loss, and more abnormal sensory conduction studies than patients with CIDP-I. Because of the greater improvement of CIDP-I patients with treatment, both groups had similar outcomes from their initial episodes of weakness. Subgroup analysis of CIDP-MGUS patients did not demonstrate differences between groups with IgM and IgG or IgA gammopathies.

Address correspondence and reprint requests to Dr Zachary Simmons, Division of Neurology, The Milton S. Hershey Medical Center, P0 Box 850, Hershey, PA 17033.

Received December 8, 1992 Accepted for publication in final form March 23, 1993.




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