DADS-M Neuropathy with Anti-Mag Antibodies...anybody else?

Posted by savomic @savomic, Nov 28, 2022

After 4 years of lower limbs weakness, I was recently diagnosed with Distal Acquired Demyelinating Symmetric with the M protein and tested positive for Anti-Mag Antibodies. Pin and needles in feet and lower limbs, ataxia, weak ankles, and tremor up to my hips. Difficulty walking and balance issues. Originally treated with IVIG with no results. Started Rituximab treatment every 3 months. Anybody else with similar issues?

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Appreciate the input. I'm just starting on this strange trip which seems to inhabit a very small corner of the neurological issues field. I'm curious if you are getting help from a Neurologist or a Hematologist? It seems both suggest the other will determine a treatment plan. So far have pain in both feet, now tingling and pain starting in both hands. Gabapentin seems to take the edge off but is not a solution, even at high doses.

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How did the Rituximab work for you?

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Profile picture for sowers11 @sowers11

Appreciate the input. I'm just starting on this strange trip which seems to inhabit a very small corner of the neurological issues field. I'm curious if you are getting help from a Neurologist or a Hematologist? It seems both suggest the other will determine a treatment plan. So far have pain in both feet, now tingling and pain starting in both hands. Gabapentin seems to take the edge off but is not a solution, even at high doses.

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I think we are in the same boat without a paddle. My neurologist placed my PROBLEM in the hands of my Hematologist. As I haven’t officially been diagnosed with anything as of yet. But with the tingling in my hands and feet, and my feet feels cold to me but not to the touch. Is a test really worth it, but of course Doctors can not diagnose without a scan or blood test.

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Each IVIG works differently. I started panzyga for five days every three months. Within the first five days my balance, dizziness and my left leg quit dragging. I am curious what the next infusion does in December. Mine is autoimmune.

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Profile picture for natelew @natelew

I think we are in the same boat without a paddle. My neurologist placed my PROBLEM in the hands of my Hematologist. As I haven’t officially been diagnosed with anything as of yet. But with the tingling in my hands and feet, and my feet feels cold to me but not to the touch. Is a test really worth it, but of course Doctors can not diagnose without a scan or blood test.

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The neurologist did not do a small fiber biopsy or emg/nerve conduction test?

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Just an FYI for all those with Anti-Mag Antibodies.
The Foundation for Peripheral Neuropathy has a research study that you might want to consider.

-- Anti-MAG Neuropathy At-Home Research Study
https://sanguinebio.com/condition/anti-mag/

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Profile picture for h37 @h37

I also have DADS with Anti-MAG. I began experiencing symptoms in 2018 and was diagnosed in 2022. I found the article "Anti-MAG neuropathy: From biology to clinical management" by Andreas Steck (the forum won't let me post a link) really helpful as I was trying to learn more, though it is field-specific reading and I understood only a fraction of it.
MAG stands for myelin associated glycoprotein. DADS-M patients have antibodies that attack this glycoprotein.
In addition to the physical symptoms (symmetrical numbness and tingling, balance challenges, etc.), elevated levels of IgM are a marker, in my case 70x the upper limit.
I’m approaching six months since my first Rituximab treatment, which was four infusions over four weeks. Some Youtube videos about the experience helped calm my nerves about the treatment. I experienced only a slight allergic reaction to the first infusion, and that was resolved with a little extra Benadryl; otherwise I was just a little fatigued the first day.
There has been some improvement for me in the tingling, and there is slightly more sensitivity in areas that feel numb. That said, some days it feels like nothing works, and some weeks it feels like improvement has faded. So it isn't a total fix for me, but I'd like to keep trying it for now. Measuring the effectiveness of Rituximab requires bloodwork that happens several months after the treatment because the growth/deterioration of myelin happens so slowly. I’m told that if the bloodwork points to progress, a maintenance dosage of one infusion every four to six months is recommended. Don't know which direction my bloodwork will take me.
Before the Rituximab, I found a little success managing symptoms with sauna, and I still use it regularly. The buzzing/tingling reaches a very high level while I’m in the sauna, but after a cold shower the rest of the day is usually calmer.

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@h37

Hello
Are you still on Rituximab treatment?
Have your conditions improved?
Appreciate you sharing any info!
Thank you

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Hello,

I’ve only had the one Rituximab treatment. My conditions have improved, but a lot of that is thanks to duloxetine, or Cymbalta, which reduces (not completely remedies) the tingling symptoms. This allows me to move and exercise in a more productive way. My neurologist has said that he would like to refrain from further Rituximab treatments until I report issues with balance and falling, which doesn’t seem like it will be a near-term problem.

Hope that helps, take care.

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Profile picture for h37 @h37

Hello,

I’ve only had the one Rituximab treatment. My conditions have improved, but a lot of that is thanks to duloxetine, or Cymbalta, which reduces (not completely remedies) the tingling symptoms. This allows me to move and exercise in a more productive way. My neurologist has said that he would like to refrain from further Rituximab treatments until I report issues with balance and falling, which doesn’t seem like it will be a near-term problem.

Hope that helps, take care.

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@h37
Thank you for sharing.

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