Portal de Periódicos da CAPES

Letters to the editor

1982; Wiley; Volume: 5; Issue: 6 Linguagem: Inglês

10.1002/mus.880050612

1097-4598

N Télerman-Toppet, M. Wittek, Michèle Bacq, P Dajez, Christian Coërs, A Fassotte, Charles K. Jablecki, Ann Benton, C Scoppetta, Carlo Casali, Mauro Piantelli, Angela Vincent, John Newsom–Davis, Alfred Stracher,

Nerve Injury and Rehabilitation

BENIGN MONOCLONAL GAMMOPATHY AND RELAPSING POLYMYOSITISBenign monoclonal gammop athy (BMG) has been re portée! in association with numerous autoimmune disor ders," including myasthenia gravis,^'"' " but so far similar findings were never mentioned in polymyositis, to our knowledge.We illustrate coexisting polymyositis and BMG in the following case report.This woman, born in 1938, had an unremarkable history, with the exception of an appendicectomy and a primary tuberculous infection during childhood.Since 1976 she has had three épisodes of severe myalgia and painful joints associated with generalized edema, oliguria, and hypotension.Slight fever with sore throat or diarrhea initiated this clinical présentation, which spontaneously regressed after three weeks.H owever, after the first attack the patient was unable to résume her work on a farm.In February 1981, during the third relapse, physical examination disclosed a good overall condition but generalized pitting edema, including the face.No dermatological lésion was observed.Diffuse muscle tenderness was increased by palpation or volun tary contraction.Slight muscle weakness was confined to the limb girdles.Stretch réflexes were hyperactive with flexor plantar response.There was no sensory defect.There was a pericardial effusion.Blood pressure was 120/80 mm H g, and the heart rate was 80/min.The following laboratory investigations were normal: blood urea, creatinine, electrolytes, sugar, white blood count, fibrinogen, lactic and pyruvic acids, uric acid, blood iron.ESR was 15 mm/h, RBC 3.95 x lOVmm^, platelets 448,000/mm''.Total proteins were 6.6 g/1 including 16.5% y globuH ns, CK was 2,600 lU (N < 80), LDH 1,029 lU (N 100240), SGOT 3,511 lU (N 219).A monoclonal peak of y globulins in the y 2 zone on agar electrophoresis was identified as an IgG K by im munofixation.There was no dépression of polyclonal immunoglobulins in February 1981 (Ig A: 209 mg%, normal 38423; Ig M 142 mg%, normal 40266; IgG 1,423 mg%, normal 5801,560).No Bence Jones or proteinuria were found in the urine.