Publications by authors named "Susan C Shin"

6 Publications

  • Page 1 of 1

Paraproteinemias and Peripheral Nerve Disease.

Clin Geriatr Med 2021 May;37(2):301-312

Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:

This article provides an overview of the clinical features, diagnosis, and treatment of the major paraprotein-related peripheral neuropathies, including monoclonal gammopathy of undetermined significance, Waldenström macroglobulinemia, POEMS syndrome, multiple myeloma, transthyretin amyloidosis, and light chain amyloidosis. For each paraprotein neuropathy, the epidemiology, demographics, systemic findings, and electrophysiologic features are presented. Pharmacologic treatment of transthyretin amyloid polyneuropathy also is reviewed.
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http://dx.doi.org/10.1016/j.cger.2021.01.004DOI Listing
May 2021

Risk of thrombotic events after inpatient intravenous immunoglobulin or plasma exchange for neurologic disease: A case-crossover study.

Muscle Nerve 2020 09 18;62(3):327-332. Epub 2020 Apr 18.

Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Introduction: Our aim in this study was to determine whether intravenous immunoglobulin (IVIg) or plasma exchange (PLEx) for treatment of neurologic disease is a trigger for thrombotic events.

Methods: Using administrative data from 2005 to 2014, we identified index admissions for thrombotic events. We performed case-crossover analyses for these admissions with previous admissions for neurologic disease with IVIg or PLEx using exposure periods of between 7 and 120 days.

Results: We identified 1.9 million admissions for venous thrombosis embolism, myocardial infarction, or acute ischemic stroke. The odds ratio for venous thrombosis embolism within a 30-day window after exposure to IVIg was 3.33 (1.34-8.30, P = .0097) and for PLEx was 4.29 (1.88-9.76, P = .0005). Myocardial infarction and acute ischemic stroke admissions were not associated with exposure to either therapy.

Discussion: Patients admitted for venous thrombosis embolism (but not acute ischemic stroke or myocardial infarction) were more likely exposed to either IVIg or PLEx during previous admission for neurologic disease.
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http://dx.doi.org/10.1002/mus.26884DOI Listing
September 2020

Neuropathy of Connective Tissue Diseases and Other Systemic Diseases.

Semin Neurol 2019 10 22;39(5):651-668. Epub 2019 Oct 22.

Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.

Peripheral neuropathy is associated with numerous systemic diseases. It is often the heralding finding, which can lead to earlier diagnoses and better outcomes. An understanding of the epidemiology and clinical features of these diseases is paramount to their diagnosis and management. This article will focus on neuropathy associated with connective tissue diseases, monoclonal gammopathies, paraneoplastic disorders, medications including chemotherapeutic agents, nutritional deficiencies, alcohol, and toxins.
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http://dx.doi.org/10.1055/s-0039-1688989DOI Listing
October 2019

Immune Myopathy With Perimysial Pathology Associated With Interstitial Lung Disease and Anti-EJ Antibodies.

J Clin Neuromuscul Dis 2017 Jun;18(4):223-227

*Neuromuscular Division, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY; and †Division of Rheumatology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

Objectives: We report a case of immune myopathy with perimysial pathology associated with anti-glycyl-transfer RNA synthetase (anti-EJ) antibody and an excellent treatment response.

Methods: Chart review.

Results: A 36-year-old woman presented with 3 months of fatigue, weight loss, progressive weakness in a scapuloperoneal distribution, and dysphagia. Nerve conduction studies, electromyography, and ultrasound suggested an irritable myopathy. She had marked elevations of creatine kinase and positive anti-glycyl-transfer RNA synthetase (anti-EJ) antibodies. A left biceps muscle biopsy revealed inflammation of the perimysium and surrounding perimysial blood vessels with focal fragmentation of the perimysium. Further evaluation revealed interstitial lung disease. Treatment with prednisone and mycophenolate mofetil led to marked clinical improvement of her symptoms.

Conclusions: Our case adds to the growing spectrum of inflammatory myopathies and highlights the importance of performing a comprehensive, multisystem workup.
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http://dx.doi.org/10.1097/CND.0000000000000148DOI Listing
June 2017

Amyloid neuropathies.

Mt Sinai J Med 2012 Nov-Dec;79(6):733-48

Mount Sinai School of Medicine, New York, NY, USA.

Peripheral neuropathy is a common complication of many of the systemic amyloidoses. Although the cause of neuropathy is not entirely clear, it is likely related to amyloid deposition within the nerve. This may lead to focal, multifocal, or diffuse neuropathies involving sensory, motor and/or autonomic fibers. The presenting symptoms depend on the distribution of nerves affected. One of the most common phenotypes is sensorimotor polyneuropathy, which is characterized by symptoms of neuropathic pain, numbness, and in advanced cases weakness. Symptoms begin in the feet and ultimately progress to the proximal legs and hands. The most common focal neuropathy is a median neuropathy at the wrist, clinically known as carpal tunnel syndrome. Carpal tunnel symptoms may include pain and sensory disturbances in the lateral palm and fingers; hand weakness may ensue if the focal neuropathy is severe. Autonomic neuropathy may affect a variety of organ systems such as the cardiovascular, gastrointestinal, and genitourinary systems. Symptoms may be non-specific making the diagnosis of autonomic neuropathy more difficult to identify. However, it is important to recognize and distinguish autonomic neuropathy from diseases of the end-organs themselves. This article reviews the inherited and acquired amyloidoses that affect the peripheral nervous system including familial amyloid polyneuropathy, and primary, secondary and senile amyloidosis. We emphasize the clinical presentation of the neurologic aspects of these diseases, physical examination findings, appropriate diagnostic evaluation, treatment and prognosis.
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http://dx.doi.org/10.1002/msj.21352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531896PMC
December 2013