Peripheral neuropathy (PN) is frequent in patients with monoclonal gammopathy due to plasma cell dyscrasia, but little is known about the comparative impact of nerve dysfunction in different disorders. We compared clinical and laboratory results between two diagnostic groups. We recruited 76 untreated multiple myeloma (MM) and 27 AL amyloidosis (ALA) patients for evaluation of symptoms, clinical findings and nerve conduction studies (NCS). We diagnosed significant PN using total neuropathy scores (TNS > 7) in 17.6% of MM and 48.1% of ALA patients and in 27.7% of MM and 35.7% of ALA patients using NCS findings. TNS score grades were significantly higher in the AL amyloidosis patients (Fisher's exact test: P = .02) but a NCS based PN diagnosis was not significantly different (Fisher's exact test: P = .13). A significantly higher TNS vibration (P = .04) and pin (P = .02) sensory sign and TNS reflex (P = .04) sign score was found in amyloidosis patients. Likewise, quantitative sensory thresholds for vibration was higher in amyloidosis patients (Welsh ANOVA: P = .01). NCS revealed signs of more frequent axonal tibial neuropathy with significantly lower motor response amplitudes (P = .02) and resulting higher TNS scores (P = .002), while sural nerve sensory response amplitudes were without significant difference (P = .86). We found more severe TNS grades of PN in AL amyloidosis patients compared with MM patients. We also found higher sensory symptoms scores and higher thresholds for vibration but similar sensory involvement using NCS. The NCS exclusively showed signs of an axonal neuropathy.

中文翻译：

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比较多发性骨髓瘤和 AL 淀粉样变性的神经病变

外周神经病变 (PN) 在浆细胞恶液质引起的单克隆丙种球蛋白病患者中很常见，但关于神经功能障碍在不同疾病中的比较影响知之甚少。我们比较了两个诊断组之间的临床和实验室结果。我们招募了 76 名未经治疗的多发性骨髓瘤 (MM) 和 27 名 AL 淀粉样变性 (ALA) 患者，用于评估症状、临床发现和神经传导研究 (NCS)。我们使用总神经病变评分 (TNS > 7) 在 17.6% 的 MM 和 48.1% 的 ALA 患者以及 27.7% 的 MM 和 35.7% 的 ALA 患者中使用 NCS 结果诊断出显着的 PN。AL 淀粉样变性患者的 TNS 评分等级显着更高（Fisher 精确检验：P = .02），但基于 NCS 的 PN 诊断没有显着差异（Fisher 精确检验：= .13）。在淀粉样变性患者中发现显着更高的 TNS 振动 ( P = .04) 和针 ( P = .02) 感觉体征和 TNS 反射 ( P = .04) 体征评分。同样，淀粉样变性患者的振动定量感觉阈值较高（威尔士方差分析：P = .01）。NCS 显示更频繁的胫骨轴突神经病变的迹象，运动反应幅度显着降低（P = .02）并导致 TNS 评分更高（P = .002），而腓肠神经感觉反应幅度没有显着差异（P= .86）。与 MM 患者相比，我们发现 AL 淀粉样变性患者的 PN 的 TNS 等级更严重。我们还发现更高的感觉症状评分和更高的振动阈值，但使用 NCS 时有类似的感觉参与。NCS 仅显示轴突神经病变的迹象。