Immune-mediated Neuropathy with Anti-disialosyl IgM Antibodies in Diffuse Large B-cell Lymphoma: A Case Report and Literature Review

Intern Med. 2015;54(13):1647-51. doi: 10.2169/internalmedicine.54.4451. Epub 2015 Jul 1.

Abstract

A 36-year-old man with diffuse large B-cell lymphoma presented with polyneuropathy, and the diagnostic work-up revealed the presence of IgM antibodies against gangliosides with disialosyl residues (GD1b, GD3). He was treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone and received high-dose intravenous immunoglobulin for the treatment of neuropathy. After initiating the treatments, the patient's neurological impairment improved dramatically. He currently remains in complete remission without a flare-up of the polyneuropathy. Based upon our experience and other case reports of lymphoma with immune-mediated neuropathy caused by anti-disialosyl ganglioside IgM antibodies, we conclude that determining the anti-ganglioside antibody profile and beginning early treatment should be considered promptly for patients with malignant lymphoma who develop polyneuropathy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antibodies / blood
  • Gangliosides / immunology
  • Humans
  • Immunoglobulin M / blood*
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / therapeutic use*
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / immunology*
  • Male
  • Peripheral Nervous System Diseases / diagnosis
  • Peripheral Nervous System Diseases / immunology*

Substances

  • Antibodies
  • Gangliosides
  • Immunoglobulin M
  • Immunoglobulins, Intravenous
  • Immunologic Factors