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Immunopathogenetic Role Of The M-Protein In Neuropathy Associated With IgA Monoclonal Gammopathy
No full textPolarity Zones and Apparent Polar Wander at the Jurassic /Cretaceous Boundary in the Southern Alps, Italy
No full textThe magnetic and nannofossil stratigraphies of several sections spanning the Jurassic/Cretaceous (J/K) boundary have been studied in the Lombardian Basin (Torre de Busi, Colle di Sogno) and Trento Plateau (Colme di Vignole, Foza). The magnetic stratigraphies span the CM16R (late Berriasian) to the CM22 (Kimmeridgian/Tithonian boundary) interval corresponding to the 138-150 Ma interval spanning the J/K boundary (142 Ma). In Lombardy, the facies transition from "Rosso ad Aptici" (siliceous limestone) to Maiolica (pelagic limestone) occurs in the latest Tithonian (CM19N-CM20N), just prior to the J/K boundary, closely synchronous with the transition from Rosso Ammonitico to Maiolica on the Trento Plateau. The identification of polarity zones is based on polarity-zone pattern fit, and the previously established correlations of polarity chrons to nannofossil events/zones. The apparent polar wander path (APWP) for each section is calibrated based on the magnetic stratigraphy and lies close to an estimated African APWP of the same age, implying very little rotation of the Lombardian and Trento plateau regions of the Southern Alps relative to Africa since latest Jurassic time. Our objective is to produce a calibrated APWP (polar wander by polarity chron), and thereby improve the definition of the Adria APWP in this interval of relatively rapid apparent polar wander
Peripheral nervous system involvement as presenting symptom of systemic B-cell lymphoma
No full textPeripheral nervous system involvement has been reported in systemic B or T cell lymphoma and may result from intraneural localization of lymphoma resulting in meningo-radiculopathy or mononeuropathies, or manifest as a sensory-motor polyneuropathy sometimes mimicking chronic inflammatory demyelinating polyneuropathy. We report two patients with a previously unknown NHL presenting in both with a stepwise progressive asymmetric multiradiculoneuropathy initially misdiagnosed as inflammatory radiculopathy. A 58-year-old man presented with a 2 year history of stepwise progressive peroneal sensory loss, impotence, and lower limb painful asymmetric neuropathy. Lumbosacral MRI was normal. Electrophysiological studies were consistent with an axonal multiradiculoneuropathy while CSF examinations repeatedly showed increased protein levels (80–91 mg/dl) with slightly increased white cells (<10 mm3) but no malignant cell. The patient repeatedly failed to respond to steroids although he consistently deteriorated at their suspension. An MRI performed 2 years later when multiple cranial nerve palsies appeared showed bilateral T1 and T2 hyperintensities in the brain and cervical spinal cord. An extensive investigation for neoplasm was negative. The patient died from an intracranial hemorrhage during anticoagulant therapy for deep vein thrombosis. Autoptic studies revealed a widespread non-Hodgkin's type B lymphoma with massive systemic and neural involvement including cauda equina and spinal cord. A 54-year-old man presented with a 1 year history of impotence, urinary incontinence, progressive asymmetric painful distal sensorimotor impairment at four limbs and prominent weight loss. Four previous CSF examinations revealed increased protein levels (80–100 mg/dl), and slightly but inconsistently increased white cells (1–11/mm3) but no malinant cells. Steroids were repeatedly ineffective although the patient consistently deteriorated whenever steroids were discontinued. On admission electrophysiological studies showed an axonal asymmetric polyradiculoneuropathy. Brain and spinal MRI was normal while bone marrow biopsy and aspiration disclosed a B cell lymphoma
Guillain-Barré syndrome after combined chemoteharpy and Rituximab in non-Hodgkin’s lymphoma
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Polarity zones and apparent polar wander at the Jurassic/Cretaceous boundary in the southern Alps, Italy
No full textRetrospective analysis of the efficacy and tolerability of drugs for neuropathic pain in peripheral neuropathy
No full textNeuropathies associated with IgG and IgA monoclonal gammopathy
No full textNeuropathy has been frequently reported in patients with monoclonal gammopathy, particularly those with monoclonal gammopathy of undetermined significance (MGUS). While the neuropathy associated with IgM-MGUS is well characterized and is often associated with a reactivity of the monoclonal protein with neural antigens, the relationship between the neuropathy and IgG and IgA MGUS is less clear. We review here the clinical, electrophysiological and pathogenetic features of neuropathies associated with IgG and IgA M-proteins in order to determine whether they represent distinct clinical entities and, most importantly, whether the finding of an IgG or IgA monoclonal gammopathy in a patient with neuropathy should led to different diagnostic or therapeutical approaches. This review will mainly focus on neuropathies associated with MGUS since the disclosure of a malignant monoclonal gammopathy, including multiple or osteosclerotic myeloma, lymphoma or primary amyloidosis, in a patient with neuropathy usually divert the therapeutical decisions to the hematologist for an appropriate therapy of the underlying lifethreatening condition
Guillain-Barré syndrome after combined chemoteharpy and Rituximab in non-Hodgkin’s lymphoma
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