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KMID : 0882420080740000184
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Korean Journal of Medicine
2008 Volume.74 No. 0 p.184 ~ p.188
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A case of chronic respiratory insufficiency caused by polyneuropathy associated with monoclonal gammopathy of undetermined significance
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Lim Chae-Young
Kwon Oh-Sung
Choi Jung-Ho
Park Dae-Rim
Lee Byoung-Hoon
Kim Sang-Hoon
Chae Jeong-Don
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Abstract
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Peripheral neuropathy, such as paraproteinemic neuropathy, is a rare neuromuscular cause of chronic ventilatory failure. Monoclonal gammopathy of undetermined significance (MGUS) is the most common cause of paraproteinemic neuropathy. We report a case of chronic ventilatory failure caused by polyneuropathy associated with MGUS. An 82-year-old man with no history of respiratory or cardiac disease visited our hospital with progressive generalized weakness and dyspnea for 6 months. Arterial blood gas analysis showed partially compensated chronic respiratory acidosis, and maximal voluntary ventilation was markedly decreased on pulmonary function testing. Nerve conduction studies and electromyography revealed diffuse sensorimotor polyneuropathy. Blood and urine protein electrophoresis and bone marrow biopsy showed IgG kappa type of MGUS. The patient was successfully supported with a non-invasive mechanical ventilator at night, and on an as-needed basis. (Korean J Med 74:S184-S188, 2008)
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KEYWORD
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Benign monoclonal gammopathy, Polyneuropathy, Respiratory insufficiency
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