Update on neuropathies associated with monoclonal gammopathy of undetermined significance (2008-2010)

Studies on paraproteinemic neuropathies have appeared in the last 2 years improving the diagnosis of these neuropathies, clarifying their pathogenesis, and informing practice by randomized clinical trial publications. Two recent randomized controlled trials with rituximab failed to provide evidence of efficacy in primary outcome measures, despite the fact that anti-myelin- associated glycoprotein (MAG) antibodies were reduced in most treated patients. This discrepancy, besides inducing the search for more effective therapy for this neuropathy, indicates that some aspects on the pathogenesis of this neuropathy probably need further clarification.