ABSTRACT
Mixed cryoglobulinemia occurs predominantly in association with chronic liver disease, infections, autoimmune diseases, and malignancies. Mixed cryoglobulinemia is classified as essential if no primary disease is identified. We report a 42-year-old woman with a painful essential cryoglobulinemic neuropathy. She developed arthralgia, purpura, and subacute multifocal sensorimotor neuropathy. Laboratory studies did not show any associated conditions except for an elevated cryoglobulin level. An electrophysiological study and nerve biopsy were indicative of multifocal axonal neuropathy. The neuropathy was stabilized with immunosuppressive treatment.
Subject(s)
Adult , Female , Humans , Arthralgia , Autoimmune Diseases , Axons , Biopsy , Cryoglobulinemia , Liver Diseases , Mononeuropathies , PurpuraABSTRACT
Multifocal motor neuropathy with conduction block (MMN) is characterized by a slowly progressive, asymmetrical weakness of the limbs without sensory loss. A differential diagnosis from other motor neuropathies has become increasingly important as MMN has proven to be a treatable disorder. We present a 45-year-old man with longstanding weakness and atrophy of the hand muscles. Electrophysiological studies revealed a typical conduction block in the bilateral median and ulnar nerves. A cycle of intravenous immunoglobulin treatment apparently did not affect the symptoms.