Clinical and laboratory features of neuropathies with serum IgM binding to TS-HDS

Muscle Nerve. 2012 Jun;45(6):866-72. doi: 10.1002/mus.23256.

Abstract

Introduction: In this investigation we studied clinical and laboratory features of polyneuropathies in patients with serum IgM binding to the trisulfated disaccharide IdoA2S-GlcNS-6S (TS-HDS).

Methods: We retrospectively compared 58 patients with selective IgM binding to TS-HDS to 41 consecutive patients with polyneuropathies without TS-HDS binding.

Results: Patients with IgM vs. TS-HDS commonly had distal, sensory, axonal neuropathies. Weakness was associated with IgM M-proteins. Hand pain and serum IgM M-proteins were more common than in control neuropathy patients. TS-HDS antibody binding was often selectively κ class. Biopsies showed capillary pathology with thickened basal lamina and C5b9 complement deposition. IgM in sera with TS-HDS antibodies often bound to capillaries.

Conclusions: Serum IgM binding to TS-HDS is associated with painful, sensory > motor, polyneuropathies with an increased frequency of persistent hand discomfort, serum IgM M-proteins, and capillary pathology. Serum IgM binding to TS-HDS suggests a possible immune etiology underlying some otherwise idiopathic sensory polyneuropathies.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Biopsy
  • Capillaries / pathology
  • Connectin
  • Disaccharides / metabolism*
  • Female
  • Humans
  • Immunoglobulin M / metabolism*
  • Male
  • Middle Aged
  • Muscle Proteins / blood*
  • Muscle, Skeletal / pathology
  • Pain / epidemiology
  • Polyneuropathies / blood*
  • Polyneuropathies / immunology
  • Polyneuropathies / pathology*
  • Prevalence
  • Retrospective Studies
  • Young Adult

Substances

  • Biomarkers
  • Connectin
  • Disaccharides
  • Immunoglobulin M
  • Muscle Proteins