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SGPG in ALS

To the Editor: Rowland et al. [1] reported an unusual case of autopsy-proven amyotrophic lateral sclerosis (ALS) in the setting of a monoclonal IgM with antibody activity against the glycolipid SGPG, but negative anti-MAG activity by immunoblot. We previously reported a patient with fatal progressive weakness and amyotrophy and IgM monoclonal activity against MAG and SGPG. Nerve biopsy disclosed severe demyelination and axonal loss …