Journal of Neurology, Neurosurgery, and Psychiatry, 1990, Vol 53, 886-889
A clinico-pathological and follow up study of 10 cases of essential type II cryoglobulinaemic neuropathy
G Cavaletti, MG Petruccioli, V Crespi, P Pioltelli, P Marmiroli and G Tredici
Department of Neurology V, University of Milan, Italy.
Ten patients with essential cryoglobulinaemia type II were examined for
peripheral nerve damage. In six cases distal symmetrical nerve involvement
was present, while in three other cases abnormalities restricted to single
nerves were found. Electrophysiological and morphological data were
consistent with axonal damage, the larger myelinated fibres being most
affected. Although active signs of vasculitis and immunoperoxidase staining
for immunoglobulins were not present, endoneurial vessels were widely
damaged, with abnormally thick endothelial cells and redundant basal
membranes. These findings, together with a patchy distribution of
myelinated fibre loss, suggest ischaemia as a cause of peripheral
neuropathy during essential cryoglobulinaemia type II. A follow up
examination, performed one year after haematologial remission, revealed
that no further peripheral nerve damage had occurred.
