Clinical and laboratory features of plasma cell dyscrasia-associated peripheral neuropathy.
| Characteristic . | MGUS . | POEMS . | Multiple Myeloma . | AL Amyloidosis . | Cryoglobulinemia . |
|---|---|---|---|---|---|
| Abbreviations: MGUS, monoclonal gammopathy of undetermined significance; BM, bone marrow. | |||||
| Reprinted with permission from Dispenzieri A. Suarez GA. Kyle RA. POEMS syndrome (osteosclerotic myeloma) In: Dyck PJ. Thomas PK, eds. Peripheral Neuropathy 4th edition. Philadelphia: Elsevier Saunders; 2005:2453–2469.40 | |||||
| Peripheral neuropathy | ~5% | 100% | 1%–8% | 15%–20% | ~25% |
| Sensory versus motor predominance | Sensory, ataxia (IgM) sensorimotor | Predominantly motor | Sensory | Sensory sensorimotor | Predominantly sensory |
| Organomegaly | – | ++ | + | ++ | ++ |
| Skin involvement | – | ++ | + | + | +++ |
| Other symptoms | Asymptomatic | Edema, fatigue, endocrine abnormalities | Bone pain, fatigue, infections | Fatigue, edema, cardiomyopathy, nephrosis | Purpura, arthralgia, hepatitis, nephritis |
| Monoclonal heavy chain | IgM >IgG >IgA | IgG > IgA >IgM | IgG > IgA | IgG > IgA > IgM | IgM >> IgG > IgA |
| Monoclonal light chain | Kappa 75% of cases | Lambda > 95% of cases | Kappa 75% of cases | Lambda 75% of cases | Kappa 75% of cases |
| Serum M-spike, gm/dL | < 3 | Usually < 2 | Usually > 3 | Usually < 2 | Usually < 2 |
| BM plasma cells, % | < 10 | Usually < 5 | > 10 | Usually < 10 | Usually < 5 |
| Skeletal lesions | – | +++ (sclerotic, mixed sclerotic & lytic) | +++ (lytic, osteoporotic, or fracture) | – | – |
| Thrombocytosis | – | ++ | - | + to ++ | + |
| Anemia | - | + | ++ | + | ++ |
| Characteristic . | MGUS . | POEMS . | Multiple Myeloma . | AL Amyloidosis . | Cryoglobulinemia . |
|---|---|---|---|---|---|
| Abbreviations: MGUS, monoclonal gammopathy of undetermined significance; BM, bone marrow. | |||||
| Reprinted with permission from Dispenzieri A. Suarez GA. Kyle RA. POEMS syndrome (osteosclerotic myeloma) In: Dyck PJ. Thomas PK, eds. Peripheral Neuropathy 4th edition. Philadelphia: Elsevier Saunders; 2005:2453–2469.40 | |||||
| Peripheral neuropathy | ~5% | 100% | 1%–8% | 15%–20% | ~25% |
| Sensory versus motor predominance | Sensory, ataxia (IgM) sensorimotor | Predominantly motor | Sensory | Sensory sensorimotor | Predominantly sensory |
| Organomegaly | – | ++ | + | ++ | ++ |
| Skin involvement | – | ++ | + | + | +++ |
| Other symptoms | Asymptomatic | Edema, fatigue, endocrine abnormalities | Bone pain, fatigue, infections | Fatigue, edema, cardiomyopathy, nephrosis | Purpura, arthralgia, hepatitis, nephritis |
| Monoclonal heavy chain | IgM >IgG >IgA | IgG > IgA >IgM | IgG > IgA | IgG > IgA > IgM | IgM >> IgG > IgA |
| Monoclonal light chain | Kappa 75% of cases | Lambda > 95% of cases | Kappa 75% of cases | Lambda 75% of cases | Kappa 75% of cases |
| Serum M-spike, gm/dL | < 3 | Usually < 2 | Usually > 3 | Usually < 2 | Usually < 2 |
| BM plasma cells, % | < 10 | Usually < 5 | > 10 | Usually < 10 | Usually < 5 |
| Skeletal lesions | – | +++ (sclerotic, mixed sclerotic & lytic) | +++ (lytic, osteoporotic, or fracture) | – | – |
| Thrombocytosis | – | ++ | - | + to ++ | + |
| Anemia | - | + | ++ | + | ++ |