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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 344:917-923 March 22, 2001 Number 12
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Case 9-2001— A 64-Year-Old Woman with Peripheral Neuropathy, Paraproteinemia, and Lymphadenopathy

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Presentation of Case

A 64-year-old, right-handed woman was admitted to the hospital because of motor and sensory impairment in her right arm.

Two years before admission, generalized lymphadenopathy had been diagnosed. At that time, the levels of urea nitrogen, creatinine, and calcium were normal. The hematocrit was 34.8 percent. Microscopical examination of a bone marrow specimen showed increased iron storage. Immunologic tests were performed (Table 1). Immunoelectrophoresis showed an IgG kappa monoclonal protein (1300 mg per deciliter). No Bence Jones protein was detected. A gallium scan showed no abnormalities. The angiotensin-converting enzyme level was normal. Repeated computed tomographic (CT) scans of . . . [Full Text of this Article]

Differential Diagnosis

Localization of the Neurologic Disorder

Evolution of the Neurologic Disorder

Causes of Mononeuritis Multiplex

Mononeuritis Multiplex with Paraproteinemia and Lymphadenopathy

Clinical Diagnosis

Dr. Kenneth C. Gorson's Diagnoses

Pathological Discussion

Anatomical Diagnosis

References


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