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CASE REPORT
Acute inflammatory neuropathy with monoclonal anti-GM2 IgM antibodies, IgM-κ paraprotein and additional autoimmune processes in association with a diffuse large B-cell non-Hodgkin's lymphoma
  1. Annette Milnik1,
  2. Dirk Roggenbuck2,
  3. Karsten Conrad3,
  4. Claudius Bartels1
  1. 1Department of Neurology, University Medical Center Magdeburg A.ö.R, Magdeburg, Germany
  2. 2GA Generic Assays GmbH, Dahlewitz, Germany
  3. 3Institute of Immunology, Technical University Dresden, Dresden, Germany
  1. Correspondence to Annette Milnik, annette.milnik{at}unibas.ch

Summary

Lymphoproliferative disorders are often associated with autoimmune processes preceding or following the occurrence of a lymphoma. Here, we describe a patient with a history of recurrent diffuse large B-cell non-Hodgkin's lymphoma who suffered from an acute inflammatory neuropathy with specific monoclonal anti-GM2 IgM antibodies and associated IgM-κ paraprotein. It was possible in this case to prove that both, anti-GM2 IgM antibodies and IgM-κ paraprotein, share the same binding characteristic. In addition, the patient possibly suffered from an immune thrombocytopenia and an early-stage bullous pemphigoid with anti-BP-230 IgG antibodies. Intravenous immunoglobulin and plasmapheresis alleviated the acute neuropathy and thrombocytopenia, while the bullous pemphigoid has been aggravated. In summary, the simultaneous occurrence of multiple autoimmune processes was a sign of a dysfunctional immune system preceding the relapse of a B-cell non-Hodgkin's lymphoma.

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