Morbidities mediated by the IgM monoclonal protein in patients with WM
| Properties of IgM monoclonal protein . | Diagnostic condition . | Clinical manifestations . |
|---|---|---|
| Pentameric Structure | Hyperviscosity | Headaches, blurred vision, epistaxis, retinal hemorrhages, leg cramps, impaired mentation, intracranial hemorrhage. |
| Precipitation on cooling | Cryoglobulinemia (type I) | Raynaud-like phenomena, acrocyanosis, ulcers, purpura, cold urticaria. |
| Auto-antibody activity to myelin associated glycoprotein (MAG), ganglioside M1 (GM1), sulfatide moieties on peripheral nerve sheaths | Peripheral neuropathies | Sensorimotor neuropathies, painful neuropathies, ataxic gait, bilateral foot drop. |
| Auto-antibody activity to IgG | Cryoglobulinemia (type II) | Purpura, arthralgias, renal failure, sensorimotor neuropathies. |
| Auto-antibody activity to red blood cell antigens | Cold agglutinins | Hemolytic anemia, Raynaud’s phenomenom, acrocyanosis, livedo reticularis. |
| Tissue deposition as amorphous aggregates | Organ dysfunction | Skin: bullous skin disease, papules, Schnitzler’s syndrome. |
| GI: diarrhea, malabsorption, bleeding. | ||
| Kidney: proteinuria, renal failure (light chain component). | ||
| Tissue deposition as amyloid fibrils (light chain component most common) | Organ dysfunction | Fatigue, weight loss, edema, hepatomegaly, macroglossia, organ dysfunction of involved organs: heart, kidney, liver, peripheral sensory and autonomic nerves. |
| Properties of IgM monoclonal protein . | Diagnostic condition . | Clinical manifestations . |
|---|---|---|
| Pentameric Structure | Hyperviscosity | Headaches, blurred vision, epistaxis, retinal hemorrhages, leg cramps, impaired mentation, intracranial hemorrhage. |
| Precipitation on cooling | Cryoglobulinemia (type I) | Raynaud-like phenomena, acrocyanosis, ulcers, purpura, cold urticaria. |
| Auto-antibody activity to myelin associated glycoprotein (MAG), ganglioside M1 (GM1), sulfatide moieties on peripheral nerve sheaths | Peripheral neuropathies | Sensorimotor neuropathies, painful neuropathies, ataxic gait, bilateral foot drop. |
| Auto-antibody activity to IgG | Cryoglobulinemia (type II) | Purpura, arthralgias, renal failure, sensorimotor neuropathies. |
| Auto-antibody activity to red blood cell antigens | Cold agglutinins | Hemolytic anemia, Raynaud’s phenomenom, acrocyanosis, livedo reticularis. |
| Tissue deposition as amorphous aggregates | Organ dysfunction | Skin: bullous skin disease, papules, Schnitzler’s syndrome. |
| GI: diarrhea, malabsorption, bleeding. | ||
| Kidney: proteinuria, renal failure (light chain component). | ||
| Tissue deposition as amyloid fibrils (light chain component most common) | Organ dysfunction | Fatigue, weight loss, edema, hepatomegaly, macroglossia, organ dysfunction of involved organs: heart, kidney, liver, peripheral sensory and autonomic nerves. |