Le Cann et al reported the CANOMAD syndrome with a neuropathy associated with monoclonal IgM gammopathy. It is classified as a neurologic monoclonal gammopathy of clinical significance. The authors are from multiple institutions in France.
CANOMAD is an acronym for chronic ataxic neuropathy, ophthalmoplegia, IgM monoclonal protein, cold agglutinins, disialosyl antibodies.
CANDA is an alternative acronym for chronic ataxic neuropathy with disialosyl antibodies.
Clinical features:
(1) chronic ataxic neuropathy (ataxia, paresthesias, hypothesia, motor weakness)
(2) ophthalmoplegia
(3) bulbar symptoms
Laboratory features:
(1) IgM monoclonal gammopathy
(2) cold agglutinins
(3) antibodies to gangliosides containing disialosyl epitopes (GD1b, GD3, GT1b, GQ1b)
Therapy with corticosteroids and immunosuppressive drugs may be ineffective. First-line therapy is IVIg infusion with a rituximab-based regimen used as second-line therapy
