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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
"central nervous system"
symptom
22q11.2 deletion syndrome
adrenomyeloneuropathy
alexander disease
aniridia
aromatase deficiency
canavan disease
child syndrome
classical phenylketonuria
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
fabry disease
gm1 gangliosidosis
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
kabuki syndrome
kallmann syndrome
kindler syndrome
krabbe disease
lamellar ichthyosis
legionellosis
liposarcoma
malignant atrophic papulosis
monosomy 21
neonatal adrenoleukodystrophy
phenylketonuria
proteus syndrome
scrub typhus
severe combined immunodeficiency
sneddon syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
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