Case of the Month #18: Peripheral Neuropathy by Dr Lorraine de Gray

Published: 29/07/2022

Preliminary Investigation and results

Preliminary Investigations requested:
1.    Nerve conduction studies to confirm/refute the diagnosis of a peripheral neuropathy

2.    Blood tests including Full Blood Count, ESR, CRP, Glycosylated Haemoglobin, Thyroid Function test, Vitamin B12 and Folate level, Serum Protein Electrophoresis

Full blood count showed a Haemoglobin of 12gm/L with an ESR of 40mmhr-1, a normal CRP, Thyroid Function test, HBA1C and Vitamin B12 and Folate level.  
Serum Protein Electrophoresis showed a monoclonal gammopathy.
Nerve conduction studies showed a sensory neuropathy with no motor involvement.

What would be your next step?