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Paraneoplastic neuropathies.
[waldenström macroglobulinemia]
This
review
describes
relevant
advances
in
paraneoplastic
neuropathies
with
emphasis
on
particular
syndromes
and
the
impact
of
new
therapies
.
Sensory
neuronopathy
may
present
with
symptoms
that
do
not
raise
the
suspicion
of
a
paraneoplastic
origin
.
A
recent
study
on
sensory
neuronopathies
of
different
causes
identified
paraneoplastic
cases
in
a
group
of
older
(
>
60
years
)
male
patients
with
subacute
onset
early
pain
,
and
frequent
involvement
of
the
arms
.
Paraneoplastic
sensorimotor
polyneuropathies
may
be
confused
with
chronic
inflammatory
demyelinating
polyneuropathy
(
CIDP
)
and
in
lymphomas
with
direct
infiltration
of
nerves
(
neurolymphomatosis
)
.
Recent
neurophysiological
studies
indicate
that
the
polyneuropathy
of
POEMS
syndrome
(
polyneuropathy
,
organomegaly
,
endocrinopathy
,
M
component
,
and
skin
changes
)
can
be
differentiated
from
CIDP
by
the
presence
of
diffuse
demyelination
and
more
severe
axonal
loss
.
Neuropathy
in
Waldenström
macroglobulinemia
is
heterogeneous
.
Up
to
38
%
have
demyelinating
features
and
the
rest
show
axonal
degeneration
due
to
different
causes
(
dysimmune
,
amyloidosis
,
or
tumoral
infiltration
)
.
Isolated
case
reports
suggest
that
the
combination
of
cyclophosphamide
and
rituximab
may
be
effective
in
paraneoplastic
neuronopathies
.
Lenalidomide
and
dexamethasone
are
effective
to
control
the
neuropathy
of
POEMS
patients
who
are
not
suitable
for
or
progress
after
autologous
stem
cell
transplantation
.
Clinical
and
neurophysiological
studies
are
helpful
to
correctly
identify
particular
paraneoplastic
neuropathies
.
Diseases
Validation
Diseases presenting
"different causes"
symptom
waldenström macroglobulinemia
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