Axonal neuropathy in a patient with monoclonal IgM kappa reactive with Schmidt-Lantermann incisures

J Neuroimmunol. 1991 Jul;33(1):73-9. doi: 10.1016/0165-5728(91)90036-7.


We report a patient with a progressive, predominantly sensory neuropathy and a IgM kappa M-protein that binds to Schmidt-Lantermann incisures. A sural nerve biopsy showed primary axonal damage and IgM deposits at Schmidt-Lantermann incisures were seen by direct immunoperoxidase. Serum from the patient injected into rat sciatic nerve reacts with the incisures as with those in the patient's nerve. The IgM kappa M-protein reacts with chondroitin sulfate C and binds to a broad nerve protein band with a mobility of between 170 and 118 kDa. Peripheral neuropathy may be related to the M-protein, which had immunocytochemical reactivity not previously described for patients with polyneuropathy and IgM monoclonal gammopathy.

Publication types

  • Case Reports

MeSH terms

  • Axons / pathology*
  • Blood Proteins / immunology*
  • Chondroitin Sulfates / analysis
  • Humans
  • Immunoblotting
  • Immunoglobulin M / analysis*
  • Immunoglobulin kappa-Chains / analysis*
  • Immunoglobulins*
  • Male
  • Middle Aged
  • Nerve Fibers, Myelinated / immunology*
  • Peripheral Nervous System Diseases / immunology*
  • Peripheral Nervous System Diseases / pathology
  • Sural Nerve / pathology


  • Blood Proteins
  • Immunoglobulin M
  • Immunoglobulin kappa-Chains
  • Immunoglobulins
  • M-proteins (Myeloma)
  • Chondroitin Sulfates