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Neurologic aspects of plasma cell disorders.
[waldenström macroglobulinemia]
Plasma
cell
disorders
make
up
a
broad
spectrum
of
diseases
that
are
characterized
by
the
appearance
of
an
abnormal
clone
of
plasma
cells
,
which
typically
manifests
as
a
production
of
monoclonal
immunoglobulin
protein
(
monoclonal
gammopathy
)
.
The
overproduction
of
plasma
cells
and
subsequent
monoclonal
gammopathy
may
be
malignant
or
a
premalignant
process
.
Monoclonal
gammopathy
of
undetermined
significance
(
MGUS
)
is
an
example
of
a
benign
process
with
a
malignant
potential
.
Multiple
myeloma
,
Waldenström
macroglobulinemia
,
POEMS
(
polyneuropathy
,
organomegaly
,
endocrinopathy
,
monoclonal
gammopathy
,
and
skin
changes
)
syndrome
,
and
AL
amyloidosis
(
immunoglobulin
light
chain
amyloidosis
)
are
examples
of
malignant
plasma
cell
disorders
which
require
treatment
.
Neurologic
manifestations
of
an
underlying
plasma
cell
disorder
can
be
variable
and
typically
challenging
to
treat
.
They
can
range
from
mild
symptoms
resulting
from
therapy
to
treat
the
disorder
to
clinically
significant
and
life-threatening
complications
related
to
the
disease
itself
.
The
peripheral
nervous
system
is
more
commonly
affected
than
the
central
nervous
system
.
Peripheral
neuropathy
is
a
frequent
manifestation
and
is
associated
with
all
of
the
plasma
cell
disorders
(
MGUS
,
multiple
myeloma
,
POEMS
syndrome
,
Waldenström
macroglobulinemia
and
AL
amyloidosis
)
with
notable
differences
in
the
signs
and
symptoms
among
the
different
groups
.
Examples
of
central
nervous
system
manifestations
include
spinal
cord
pathology
,
such
as
spinal
cord
compression
from
vertebral
collapse
or
plasmacytoma
.
Intracranial
involvement
is
rare
but
can
occur
from
brain
parenchyma
infiltration
,
leptomeningeal
involvement
,
and
tumor
-like
lesions
,
such
as
amyloidoma
in
AL
amyloidosis
and
plasmacytoma
in
multiple
myeloma
.
Encephalopathy
can
occur
due
to
metabolic
disturbances
related
to
the
underlying
plasma
cell
disorder
,
including
hypercalcemia
and
uremia
in
multiple
myeloma
and
hyperviscosity
in
Waldenström
macroglobulinemia
.
Included
in
this
chapter
is
a
detailed
discussion
of
the
various
plasma
cell
disorders
and
their
spectrum
of
neurologic
manifestations
.
Diseases
Validation
Diseases presenting
"polyneuropathy"
symptom
erythropoietic protoporphyria
fabry disease
focal myositis
gm1 gangliosidosis
kallmann syndrome
primary hyperoxaluria type 1
systemic capillary leak syndrome
triple a syndrome
waldenström macroglobulinemia
This symptom has already been validated