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Ofatumumab in chronic inflammatory demyelinating polyradiculoneuropathy associated with monoclonal gammopathy of undetermined significance: a case report

Year: 2026

Type: article

Abstract: This case report describes the successful use of ofatumumab, a fully humanized anti-CD20 monoclonal antibody, in a 62 years old male with monoclonal gammopathy of undetermined significance (MGUS) associated chronic inflammatory demyelinating polyneuropathy. The patient presented with acute limb weakness, glove-like paresthesia, and respiratory involvement, alongside elevated anti-ganglioside antibodies (anti-GM4 IgM and IgG) and λ-type IgM-M proteinemia. Despite initial therapies including intravenous immunoglobulin, efgartigimod, and immunosuppressants, he experienced recurrent relapses. Treatment with ofatumumab combined with methylprednisolone resulted in complete peripheral CD19+ B cell depletion, improved nerve conduction velocities, and sustained clinical remission. The findings highlight the efficacy of ofatumumab in targeting pathogenic CD20+ B cell clones, thereby disrupting autoantibody production implicated in immune mediated peripheral nerve injury. This case underscores the potential of B cell directed therapy for refractory MGUS associated neuropathies, offering a novel approach when conventional immunotherapies fail. Further multicenter studies are warranted to establish standardized protocols and optimize long term outcomes through combination regimens targeting both B cell and plasma cell compartments.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1633753

Authors: Min Deng, Jing Xiong, Zhaohong Kong, Ying Yu, Tao Li

Institution: Renmin Hospital of Wuhan University

Language: English

Topic: Peripheral Neuropathies and Disorders

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801