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Anti-myelin-associated glycoprotein (MAG) levels were extremely elevated, &gt;70 000 BTU. Bone marrow biopsy revealed 15%\u201320%\u2009small B cells and positive MYD88 mutation, indicative of Waldenstrom macroglobulinaemia. A diagnosis of Waldenstrom-associated anti-MAG paraprotein neuropathy with intentional (neurogenic) tremor was made. Repeat nerve conduction study showed a severe sensory demyelinating neuropathy with no axonal lesion. Treatment with rituximab was given for 1\u2009month with minimal improvement. Repeat anti-MAG levels dropped to 53 670 BTU, with minimal clinical improvement.<\/jats:p>","DOI":"10.1136\/bcr-2018-228376","type":"journal-article","created":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T08:09:37Z","timestamp":1554106177000},"page":"e228376","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Waldenstrom-associated anti-MAG paraprotein polyneuropathy with neurogenic tremor"],"prefix":"10.1136","volume":"12","author":[{"given":"Carlo","family":"Canepa","sequence":"first","affiliation":[{"name":"Department of Neurology, James Paget University Hospital, Great Yarmouth, 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