@article {541316,
	title = {A Man with Paraneoplastic Retinopathy plus Small Fiber Polyneuropathy Associated with Waldenstr{\"o}m Macroglobulinemia (Lymphoplasmacytic Lymphoma): Insights into Mechanisms},
	journal = {Ocul Immunol Inflamm},
	volume = {23},
	number = {5},
	year = {2015},
	month = {2015},
	pages = {405-9},
	abstract = {PURPOSE: To report a well-characterized Waldenstr{\"o}m{\textquoteright}s macroglobulinemia (WM) case that provides insight into the mechanisms of two paraneoplastic complications -- cancer-associated retinopathy (CAR) and small fiber polyneuropathy (SFPN).

METHODS: Retrospective medical chart review.

RESULTS: A 58-year old man with WM developed vision loss and bilateral lower extremity pain. CAR was diagnosed by history, a depressed electroretinogram (ERG) and positive anti-retinal antibodies. SFPN diagnosis was based on abnormal autonomic nerve function testing and a distal-leg skin biopsy that demonstrated absent epidermal small-fiber innervation, IgM and complement deposition and microvasculopathy. Plasma exchange (PLEX) led to dramatic pain relief and subjective improvement in eye symptoms along with improvement of some ERG parameters. Repeat skin biopsy after treatment showed less microvascular abnormalities and decreased complement deposition.

CONCLUSIONS: The concurrence of CAR and SFPN in this patient suggest that both were complications of WM and their common response to PLEX suggests co-mediation by humoral factors that accessed target antigens through IgM-triggered, complement-mediated vascular damage.},
	keywords = {Diagnosis, Differential, Electroretinography, Fluorescein Angiography, Fundus Oculi, Humans, Male, Middle Aged, Nerve Fibers, Paraneoplastic Syndromes, Periodicity, Polyneuropathies, Retina, Retinal Diseases, Retrospective Studies, Skin, Waldenstrom Macroglobulinemia},
	issn = {1744-5078},
	doi = {10.3109/09273948.2014.884599},
	author = {Liu, Yingna and Magro, Cynthia and Loewenstein, John I and Makar, Robert S and Stowell, Christopher P and Dzik, Walter H and Hochberg, Ephraim P and Oaklander, Anne Louise and Sobrin, Lucia}
}
