Long-term response to rituximab and fludarabine combination in IgM anti-myelin-associated glycoprotein neuropathy.

We report the clinical response and biological effects of treatment with rituximab and fludarabine (RF) in five patients with IgM anti-myelin-associated glycoprotein (MAG) demyelinating neuropathy. Between November 2006 and October 2009, four men and one woman aged 52-85 years received intravenous rituximab at 375 mg/m(2) on day 1 and oral fludarabine at 40 mg/m(2) /day from days 1 to 5, in a treatment cycle that was repeated every month for up to 6 months. Two patients had IgM monoclonal gammopathy of undetermined significance and three low tumor mass Waldenstrom's macroglobulinemia.

Lower limb neuropathy after spinal anesthesia in a patient with latent thiamine deficiency.

We present the case of a 65-year-old man with latent thiamine deficiency who manifested lower limb neuropathy after receiving spinal anesthesia. We discuss our care of this patient and include a discussion of thiamine deficiency generally, its possible origins, symptoms, and recommended techniques for treatment of these patients.