Monoclonal gammapathy is not one specific disease entity, but a group of diseases of unknown etiology. Their common feature is the growth of a single clone of plasmocytes, i.e. lymphoid cells of the B-line of the hematopoietic system, capable of producing antibodies. What are the symptoms of clonal gammapathy and how is it treated?

Monoclonal gammapathyis often diagnosed accidentally during prophylactic laboratory tests, or the patient reports symptoms suggesting its occurrence. In the course of monoclonal gammapathy, a single clone of plasmocytes, i.e. lymphoid cells of the hematopoietic system, capable of producing antibodies, grows. They arise from one cell and secrete the so-called an M protein composed of two identical heavy chains and two identical light chains. This is manifested by the monoclonal protein visible in the proteinogram. If monoclonal gammapathy is suspected, the diagnosis should be confirmed by electrophoresis, which will show the presence of the M protein. Subsequently, immunofixation will identify the type of heavy or light chains.

Monoclonal gammapathy: symptoms

Some gammapathy is completely asymptomatic and the only difference is the presence of an abnormal protein. Others, on the other hand, may be aggressive. Excessive production of the M protein can lead to a reduction in the amount of residual immunoglobulins and thus cause a decrease in immunity or blood clotting disorders. The accumulation of protein in the tissues causes, for example, damage to the kidneys. The infiltration of bone tissue leads to the formation of osteoporosis and an increase in calcium levels in the body.

Monoclonal Gammapatie: classification

  • MGUS (monoclonal gammapathy of undefined importance) - characterized by small amounts of monoclonal protein in the serum and mild course, does not damage target organs:

- MGUS mild with overproduction of immunoglobulin G, A or D; less often the disease relates to the excessive production of immunoglobulin M-MGUS accompanying other diseases - MGUS in the course of chronic infections (bacterial, viral, parasitic) - Bence Jones idiopathic proteinuria

  • malignant monoclonal gammapathy - the course is symptomatic andprogressive:

- multiple myeloma (multiple myeloma, Kahler's disease) - POEMS syndrome - a rare type of multiple myeloma, the name derives from the first letters of the most common symptoms: polyneuropathy, organomegaly, endocrinopathy and monoclonal gammapathy - plasma leukemia cell leukemia - PCL) - is the most severe form of myeloma, usually is the final stage of the progression of multiple myeloma, but there are also forms diagnosed with Waldenström's de novomacroglobulinemia - it is a rare type of non-Hodgkin's lymphoma, the essence of which is uncontrolled proliferation of B cells, which overproduce abnormal monoclonal IgM protein

  • diseases with the deposition of immunoglobulin chains:

- diseases with systemic deposition of heavy and light chains - primary amyloidosis - disease with deposition of biologically inactive protein with β configuration and unbranched structure

Monoclonal gammapatie: treatment

In the case of MGUS or asymptomatic myeloma, treatment is not necessary and only regular check-ups with serum and urine protein electrophoresis are recommended. Treatment of symptomatic gammapathy should be determined individually, taking into account the age and condition of the patient.

Category:

Cardiology