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Antibodies against myelin-associated glycoprotein (MAG) almost invariably appear in the context of an IgM monoclonal gammopathy associated neuropathy. Very few cases of anti-MAG neuropathy lacking IgM-monoclonal gammopathy have been reported. We investigated the presence of anti-MAG antibodies in 69 patients fulfilling diagnostic criteria for CIDP. Anti-MAG antibodies were tested by ELISA and confirmed by immunohistochemistry. We identified four (5.8%) anti-MAG positive patients without detectable IgM-monoclonal gammopathy. In two of them, IgM-monoclonal gammopathy was detected at 3 and 4-year follow-up coinciding with an increase in anti-MAG antibodies titers. In conclusion, anti-MAG antibody testing should be considered in chronic demyelinating neuropathies, even if IgM-monoclonal gammopathy is not detectable.

Citation

Elba Pascual-Goñi, Lorena Martín-Aguilar, Cinta Lleixà, Laura Martínez-Martínez, Manuel J Simón-Talero, Jordi Díaz-Manera, Elena Cortés-Vicente, Ricard Rojas-García, Esther Moga, Cándido Juárez, Isabel Illa, Luis Querol. Clinical and laboratory features of anti-MAG neuropathy without monoclonal gammopathy. Scientific reports. 2019 Apr 16;9(1):6155

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PMID: 30992531

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