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Physical Medicine and Rehabilitation... Feb 2008Neuromuscular disorders associated with monoclonal gammopathies are usually uncovered in approximately 10% of patients presenting with peripheral neuropathy complaints.... (Review)
Review
Neuromuscular disorders associated with monoclonal gammopathies are usually uncovered in approximately 10% of patients presenting with peripheral neuropathy complaints. This discovery should prompt further evaluation for underlying plasma cell dyscrasias. The most frequent monoclonal disorders associated with neuropathy are smoldering myeloma, multiple myeloma, Waldenström macroglobulinemia, solitary plasmacytoma, systemic immunoglobulin light chain (AL) amyloidosis, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes), and cryoglobulinemia. If these are excluded by careful evaluation the patient is classified as having monoclonal gammopathy of undetermined significance. Diagnostic criteria, risk stratification to determine prognosis, and current management for these disorders are reviewed in this article.
Topics: Female; Humans; Male; Multiple Myeloma; Neuromuscular Diseases; Paraproteinemias; Risk Factors
PubMed: 18194750
DOI: 10.1016/j.pmr.2007.10.005 -
European Journal of Medical Research Jul 2021This study aimed to analyze the clinicopathological characteristics of patients with paraproteinemia and renal damage.
BACKGROUND
This study aimed to analyze the clinicopathological characteristics of patients with paraproteinemia and renal damage.
METHODS
Ninety-six patients from 2014 to 2018 with paraproteinemia and renal damage were enrolled and the clinical data, renal pathology, treatment and prognosis data were collected.
RESULTS
A total of 96 patients (54 male and 42 female), accounting for 2.7% of all renal biopsies, were enrolled in this study. Among them, 42 were monoclonal gammopathy of renal significance (MGRS), 21 were renal monotypic immunoglobulin alone (renal monoIg), and 19 were monoclonal gammopathy of undetermined significance (MGUS). Individuals with multiple myeloma (MM) accounted for the fewest number of patients (n = 14). In the MGRS group, the main diseases were amyloidosis (n = 25) and cryoglobulinemic glomerulonephritis (n = 7), while in the MM group, the main diseases were cast nephropathy (n = 9) and light chain deposit disease (n = 3). In the MGUS group, it was mainly IgA nephropathy (IgAN, n = 10) and idiopathic membranous nephropathy (n = 5); while in the renal monoIg group, most of the cases were IgAN (n = 19). Chemotherapy was mainly administered to patients in the MM group, while immunosuppression therapy was mostly administered to patients in the renal monoIg group. Most patients with renal monoIg exhibited a major response, followed by the patients with MGUS and MGRS, while most of the patients with MM had a partial response but none had a major response. Approximately more than half (57.1%) of the patients with MM progressed to end-stage renal disease (ESRD), followed by MGRS (33.3%); however, the mortality rate was low in both the MGRS and MM groups. The survival analysis reviewed that serum creatinine, hemoglobin levels, and the serum κ/λ ratio were independent risk factors for ESRD in patients with MGRS.
CONCLUSIONS
The clinicopathological changes in patients with MGRS were between those in patients with MM and MGUS. The treatment for MGRS and MM was more intensive, and the overall mortality rate was low. Both MGUS and renal monoIg alone exhibited slighter clinicopathological features than MGRS and MM, and the treatment was focused mostly on primary renal diseases.
Topics: Adult; Biopsy; China; Female; Humans; Incidence; Kidney; Kidney Diseases; Male; Middle Aged; Paraproteinemias; Prognosis
PubMed: 34217367
DOI: 10.1186/s40001-021-00538-2 -
Micron (Oxford, England : 1993) 2008A typical monoclonal IgG dysglobulinemia whether benign (monoclonal gammopathy of undetermined significance, MGUS) or malignant can give rise to peripheral neuropathy by... (Review)
Review
A typical monoclonal IgG dysglobulinemia whether benign (monoclonal gammopathy of undetermined significance, MGUS) or malignant can give rise to peripheral neuropathy by damaging nerves. At first, neurotoxicity of the chemotherapy if the patient is treated must be ruled out in such cases. Indeed, a variety of other mechanisms have been described: endoneurial deposits of immunoglobulin, infiltration of the immunoglobulin within myelin sheaths, POEMS syndrome, deposits of amyloid, chronic inflammatory demyelinating polyradiculoneuropathy and infiltration of malignant cells. Ultrastructural examination of a nerve biopsy can be decisive in combination with routine histological and immunopathological examinations. Characterization of the mechanism of the neuropathy in a dysglobulinemic context is important as it governs therapeutic options, which in certain cases are particularly beneficial.
Topics: Humans; Immunoglobulin G; Microscopy, Electron; Paraproteinemias; Peripheral Nervous System Diseases; Plasmacytoma
PubMed: 17291771
DOI: 10.1016/j.micron.2006.12.005 -
Mayo Clinic Proceedings Nov 1997To report three cases of pulmonary or myocardial disease (or both) and necrobiotic xanthogranuloma. (Review)
Review
OBJECTIVE
To report three cases of pulmonary or myocardial disease (or both) and necrobiotic xanthogranuloma.
MATERIAL AND METHODS
Giant cell granulomas of the lung and myocardium were demonstrated in three patients who had pulmonary and myocardial lesions of necrobiotic xanthogranuloma in conjunction with skin lesions, leukopenia, paraproteinemia, and complement deficiencies. The patients were two men who were 47 and 64 years of age and a 39-year-old woman.
RESULTS
Biopsies of skin and visceral lesions showed asteroid and cytoplasmic inclusions. B-cell lymphoid nodules were found. In one of the male patients, a major clonal T-cell receptor gene rearrangement was detected in the peripheral blood. Prednisone was ineffective in two of the patients. The other patient experienced regression of skin lesions and diminishment of a chest nodule after receiving alkylating agent therapy.
CONCLUSION
Establishing the correct diagnosis is important, and apparently it is possible to establish the nature of the myocardial and pulmonary lesions with use of appropriate scans and by biopsy. Successful treatment of necrobiotic xanthogranuloma skin lesions with corticosteroids or alkylating agents (or both) implies that evolution of serious disease that compromises the heart and lungs could be controlled.
Topics: Adult; Autopsy; Biopsy; Cardiomyopathies; Diagnosis, Differential; Female; Granuloma, Giant Cell; Humans; Lung Diseases; Male; Middle Aged; Necrobiosis Lipoidica; Paraproteinemias; Skin; Xanthomatosis
PubMed: 9374976
DOI: 10.4065/72.11.1028 -
Leukemia & Lymphoma Jan 2004The frequency and clinical significance of paraproteinemia in patients receiving hematopoietic stem cell (HSC) transplants were assessed. Of 66 patients with hematologic...
The frequency and clinical significance of paraproteinemia in patients receiving hematopoietic stem cell (HSC) transplants were assessed. Of 66 patients with hematologic malignancies, excluding multiple myeloma who received an allogeneic or autologous HSC transplant, paraproteins were detected in 12 patients using immunoelectrophoresis. None of the patients showed paraproteinemia before HSC transplantation. The class of paraproteins most commonly seen was IgG. In 9 of these 12 patients (75%), a paraprotein was detected continuously after HSC transplantation for an average duration of 464 days, while others demonstrated a transient appearance of the protein. Paraproteinemia after HSC transplantation was not related to the stem cell source, (allograft vs. autograft), age, gender, viral infection and graft-vs.-host disease (GVHD). None of the patients developed plasma cell dyscrasia after the appearance of the paraprotein, while 1 patient developed secondary acute lymphoblastic leukemia. These findings indicate that paraproteinemia after HSC transplantation may be caused by an aberrant immune reconstitution after both allogeneic and autologous HSC transplantation. A long-term follow-up of patients with paraproteinemia after HSC transplantation is needed to confirm this finding in a larger series of patients.
Topics: Adolescent; Adult; Female; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; Paraproteinemias
PubMed: 15061209
DOI: 10.1080/1042819031000139729 -
Indian Journal of Dermatology,... 2023
Topics: Humans; Pancytopenia; Paraproteinemias
PubMed: 35146977
DOI: 10.25259/IJDVL_425_2021 -
JAMA Dermatology Jul 2014
Topics: Adult; Female; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Middle Aged; Paraproteinemias; Range of Motion, Articular; Scleredema Adultorum
PubMed: 24847975
DOI: 10.1001/jamadermatol.2013.8835 -
La Ricerca in Clinica E in Laboratorio 1985According to the various case series, both myelomatous and non-myelomatous paraproteinemias are associated with a second malignant neoplasia in a frequency that ranges...
According to the various case series, both myelomatous and non-myelomatous paraproteinemias are associated with a second malignant neoplasia in a frequency that ranges between 10 and 22%. This association, with a frequency higher than that statistically expected, is 2 to 4 times higher when compared to the association between two tumors of other origin. The association paraproteinemia-neoplasia was found in 10% of cases of our series of 311 paraproteinemias. In this series epithelial neoplasias are associated with paraproteinemias more frequently than lymphoreticular neoplasias. As far as the Ig class is concerned, there appears to be a prevalence of IgM paraproteinemias, which accounts for 22.5%, while it is only 9% in the general survey of paraproteinemias. The prevalence of the IgM class should be related to the high degree of association (approximately 50%) between the IgM paraproteinemias and lymphoreticular neoplasias. The frequent association with a second neoplasia, common to other malignancies of the B-cell line (chronic lymphocytic leukemia, myeloma), must be considered a greater risk in the prognostic evaluation of a paraproteinemia. This should make us more cautious in affirming the 'benignancy' of every non-myelomatous paraproteinemia.
Topics: Adult; Aged; Female; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Male; Middle Aged; Neoplasms; Paraproteinemias
PubMed: 4059800
DOI: 10.1007/BF03029826 -
British Journal of Hospital Medicine... Jun 2015
Topics: Asymptomatic Diseases; Diagnosis, Differential; Disease Management; Electrophoresis; Humans; Immunoglobulin Light Chains; Multiple Myeloma; Paraproteinemias; Prognosis
PubMed: 26053916
DOI: 10.12968/hmed.2015.76.6.C82 -
Kidney International Sep 2010
Topics: Aged, 80 and over; Creatine; Diagnostic Errors; Humans; Male; Methods; Paraproteinemias; Paraproteins
PubMed: 20805820
DOI: 10.1038/ki.2010.246