Clinical and laboratory features of neuropathies with serum IgM binding to TS-HDS
Article first published online: 10 MAY 2012
Copyright © 2011 Wiley Periodicals, Inc.
Muscle & Nerve
Volume 45, Issue 6, pages 866–872, June 2012
How to Cite
Pestronk, A., Schmidt, R. E., Choksi, R. M., Sommerville, R. B. and Al-Lozi, M. T. (2012), Clinical and laboratory features of neuropathies with serum IgM binding to TS-HDS. Muscle Nerve, 45: 866–872. doi: 10.1002/mus.23256
- Issue published online: 10 MAY 2012
- Article first published online: 10 MAY 2012
- Accepted manuscript online: 28 NOV 2011 12:59AM EST
- Manuscript Accepted: 21 NOV 2011
- heparin disaccharide;
- IgM antibody;
- sensory neuropathy
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).
We retrospectively compared 58 patients with selective IgM binding to TS-HDS to 41 consecutive patients with polyneuropathies without TS-HDS binding.
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.
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. Muscle Nerve 45: 866–872, 2012