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Paraprotein

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https://www.readbyqxmd.com/read/28202168/paraprotein-associated-thrombotic-microangiopathy-expanding-the-spectrum-of-renal-disease-related-to-plasma-cell-dyscrasias
#1
Mercury Lin, Mark Haas
Plasma cell dyscrasias are associated with a variety of renal diseases, most resulting from the deposition of intact or altered monoclonal paraproteins within the renal parenchyma. Much less commonly, renal disease resulting from monoclonal gammopathies has been reported without actual accumulation of the paraprotein or a derivative of it within the kidney. One such instance involves thrombotic microangiopathy (TMA), which is a consequence of endothelial cell injury. New data from the Mayo Clinic indicate that the association of TMA with monoclonal gammopathies is far more frequent than previously appreciated...
March 2017: Kidney International
https://www.readbyqxmd.com/read/28185466/-analytical-interference-leading-to-a-diagnosis-of-lymphoproliferative-disorder
#2
I Kurfürstová, T Šálek, E Kadlčková, M Pšenčík
BACKGROUND: Monoclonal immunoglobulins (paraproteins) are produced by B lymphocytes in lymphoproliferative disorders. A single monoclonal immunoglobulin is homogeneous in terms of its structure, and it can occur in human serum at high concentration and cause significant interference in laboratory assays. CASE: We present a case of an 84-year-old man who was admitted to the hospital for progression of dyspnea. Basic laboratory tests showed a serum concentration of conjugated bilirubin, measured using the diazo spectrophotometric method, which was much higher than that of total bilirubin...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28185460/-daratumumab-hope-for-myeloma-patients-a-challenge-for-clinical-laboratories
#3
T Jelínek, M Kořístka, Z Čermáková, R Hájek
Monoclonal antibodies represent a standard part in the treatment of oncologic patients, but their efficacy in multiple myeloma used to be unsatisfactory. Daratumumab monotherapy was approved by the American FDA in 2015, after unprecedented results were obtained in a heavily pre-treated group of patients. In 2016 daratumumab was approved in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of myeloma patients who have received at least one prior therapy.The toxicity of the drug is low, and is dominated by infusion-related reactions in more or less half of patients...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28182355/pure-red-cell-aplasia-associated-with-monoclonal-gammopathy-of-undetermined-significance-and-literature-review
#4
Hyunjung Gu, Woo-In Lee, You La Jeon, So Young Kang, Myeong Hee Kim, Tae Sung Park
BACKGROUND: Pure red cell aplasia (PRCA) is an uncommon disease which involves an almost complete absence of the erythroid lineage in bone marrow (BM) and causes severe anemia. Cases due to monoclonal gammopathy occurring in plasma cell disorder have been infrequently reported. Here we report a case of PRCA associated plasma cell disorder, especially monoclonal gammopathy of undetermined significance (MGUS). METHODS: A 55-year-old male visited the ER due to general weakness...
February 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28174184/multiple-myeloma-presenting-with-bilateral-ankle-pain-microangiopathy-and-complicated-by-streptococcal-meningitis-and-pneumocystis-carinii-pneumonia
#5
Louise Dunphy, Neeraj Singh, Elizabeth Keating
Multiple myeloma is characterised by the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. This clone of plasma cells proliferates in the bone marrow, resulting in extensive skeletal destruction with osteolytic lesions, osteopenia and pathological fractures. Additional disease-related complications include hypercalcaemia, renal insufficiency, anaemia and infection. We present the case of a 64-year-old woman presenting with rapid onset, painful distal symmetrical lower limb weakness and an acute kidney injury...
February 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28116769/capillary-electrophoresis-analysis-of-n-glycosylation-changes-of-serum-paraproteins-in-multiple-myeloma
#6
Zsuzsanna Kovacs, Adam Simon, Zoltan Szabo, Zsolt Nagy, Laszlo Varoczy, Ildiko Pal, Eszter Csanky, Andras Guttman
Multiple myeloma (MM) is an immedicable malignancy of the human plasma cells producing abnormal antibodies (also referred to as paraproteins) leading to kidney problems and hyperviscosity syndrome. In this paper we report on the N-glycosylation analysis of paraproteins from total human serum as well as the Fc and Fab κ/λ light chain fractions of papain digested immunoglobulins from multiple myeloma patients. Capillary electrophoresis with laser induced fluorescence detection (CE-LIF) was used for the analysis of the N-glycans after endoglycosidase (PNGase F) mediated sugar release and fluorophore labeling (APTS)...
January 24, 2017: Electrophoresis
https://www.readbyqxmd.com/read/28115403/deceiving-proteins-a-case-of-lymphoma-and-high-creatinine
#7
El Hakem Abdelkarim Metraiah, Helen Regan, Johanna Louw, Dana Kidder
Estimation of kidney function by measuring serum creatinine is one the commonest laboratory tests conducted in clinical practice. Enzymatic methods are often used to measure serum creatinine. Clinicians should be aware of the limitations of these methods, such as test interference with paraproteins.We present a case of falsely elevated serum creatinine in a patient referred for renal biopsy. The combination of fluctuating creatinine and normal blood urea level was unusual. Serum protein electrophoresis revealed the presence of an IgM paraprotein...
January 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28106236/chorioretinal-folds-in-a-patient-with-multiple-myeloma-treated-with-stem-cell-transplant
#8
Jia S Poon, Kaveh Vahdani, Adam P Booth
PURPOSE: To report an unusual case of bilateral choroidal folds related to multiple myeloma. METHODS: In this case report, fundus photography, fundus fluorescein angiography, fundus autofluorescence, and B-ultrasonography were used to assess posterior segment changes. RESULTS: A 55-year-old woman with history of multiple myeloma was found to have abnormal fundi. Clinical examination and investigations confirmed chorioretinal folds, which was considered to be related to myeloma...
January 16, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28101022/necrobiotic-xanthogranuloma-in-a-patient-with-multiple-myeloma
#9
Marlies Wruhs, Robert Feldmann, Isabelle Sawetz, Friedrich Breier, Andreas Steiner
An 82-year-old woman presented with a 9-month history of multiple, well-defined skin lesions on her neck and upper chest, progressively increasing in size. Histological examination of a skin biopsy showed a regular epidermis. In the dermis, granulomatous changes with central necrobiosis were found which extended focally into the subcutaneous fat. The necrobiotic areas were surrounded by Touton cells and foreign-body giant cells. Laboratory analysis revealed leucopenia. Serum electrophoresis and immunofixation disclosed the presence of an IgG-λ paraprotein...
September 2016: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28076910/treatment-of-patients-with-waldenstr%C3%A3-m-macroglobulinaemia-clinical-practice-guidelines-from-the-myeloma-foundation-of-australia-medical-and-scientific-advisory-group
#10
Dipti Talaulikar, Constantine S Tam, Douglas Joshua, Joy Phoebe Ho, Jeff Szer, Hang Quach, Andrew Spencer, Simon Harrison, Peter Mollee, Andrew W Roberts, Noemi Horvath, Cindy Lee, Andrew Zannettino, Ross Brown, Bradley Augustson, Wilfrid Jaksic, John Gibson, Anna Kalff, Anna Johnston, Judith Trotman, Akash Kalro, George Grigoriadis, Chris Ward, H Miles Prince
Waldenström macroglobulinaemia (WM) is an indolent B-cell malignancy characterised by the presence of immunoglobulin M (IgM) paraprotein and bone marrow infiltration by clonal small B lymphocytes, plasmacytoid lymphocytes and plasma cells. The symptoms of WM are protean, often follow an asymptomatic phase and may include complications related to the paraneoplastic effects of IgM paraprotein. The revised 2016 World Health Organization classification includes the MYD88 L265P mutation, which is seen in >90% of cases, within the diagnostic criteria for WM...
January 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28076302/detecting-paraprotein-interference-on-a-direct-bilirubin-assay-by-reviewing-the-photometric-reaction-data
#11
Elena García-González, Maite Aramendía, Ricardo González-Tarancón, Naiara Romero-Sánchez, Luis Rello
BACKGROUND: The direct bilirubin (D-Bil) assay on the AU Beckman Coulter instrumentation can be interfered by paraproteins, which may result in spurious D-Bil results. In a previous work, we took advantage of this fact to detect this interference, thus helping with the identification of patients with unsuspected monoclonal gammopathies. In this work, we investigate the possibility to detect interference based on the review of the photometric reactions, regardless of the D-Bil result. METHODS: The D-Bil assay was carried out in a set of 2164 samples...
January 11, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28068803/annals-express-artifactual-25-oh-vitamin-d-level-in-multiple-myeloma
#12
Michal Wen Sheue Ong, Rashim Salota, Tracy Reeman, Lapsley Marta, Lydia Jones
The most commonly used techniques to measure vitamin D are automated immunoassays which are known to be affected by interferences, especially from immunoglobulins present in the patient's serum. We present a case of a patient with myeloma in whom interference with the vitamin D assay was identified. An eighty-three year old female, known to have IgG myeloma was found to have a high concentration of 25-OH vitamin D on a routine test without any signs of vitamin D toxicity. She was not taking vitamin D supplements or any other multivitamin preparation and had minimal sun exposure...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/27994856/c3-glomerulopathy-in-adults-a-distinct-patient-subset-showing-frequent-association-with-monoclonal-gammopathy-and-poor-renal-outcome
#13
Isaac E Lloyd, Alexander Gallan, Hunter K Huston, Kalani L Raphael, Dylan V Miller, Monica P Revelo, Mazdak A Khalighi
BACKGROUND: C3 glomerulopathy (C3G) includes both C3 glomerulonephritis (C3GN) and dense deposit disease (DDD) and is defined by C3-dominant deposits on immunofluorescence. Dysfunction of the alternative pathway (AP) of complement is central to the pathophysiology of C3G and young patients often harbor genetic alterations of AP mediators. Recently, a link between C3G and paraproteinemia has been established. We performed this study to better characterize older patients with C3G where this association is more frequently seen...
December 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27957423/crystalline-podocytopathy-and-tubulopathy-without-overt-glomerular-proteinuria-in-a-patient-with-multiple-myeloma
#14
Eun Jeong Lee, Su Yeon Lee, So Young Park, Yonjin Kim, Jae Shin Choi, Mi Jeoung Kim, Ji Hyeon Park, Jung Eun Lee, Ghee Young Kwon, Yoon-Goo Kim
Crystalline nephropathy is a rare yet well-known condition associated with multiple myeloma and other light chain-secreting disorders. Paraproteins that are resistant to proteolysis crystallize within proximal tubular cells and cause light-chain proximal tubulopathy, which presents clinically as Fanconi syndrome. Podocytes are rarely affected, and the crystalline inclusions within podocytes are typically precipitated, yielding significant glomerular proteinuria. Here we report a case of extensive crystalline inclusions primarily within podocytes and proximal tubules that presented only with Fanconi syndrome and renal insufficiency...
December 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27927893/paraprotein-related-kidney-disease-attack-of-the-killer-m-proteins
#15
Mark A Perazella, Kevin W Finkel
Paraproteins are monoclonal Igs or their components (light or heavy chains) that are produced by a clonal population of mature B cells, most commonly plasma cells. These paraproteins or monoclonal proteins are secreted into the blood and subsequently filtered by the glomerulus before entering into urine, where they can cause various types of kidney disease, including both glomerular and tubulointerstitial injuries. Furthermore, a monoclonal protein that causes a specific glomerular or tubulointerstitial lesion in a human can reproducibly cause the same pathology when injected into an animal, supporting unique paraprotein characteristics...
December 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27868410/-expression-of-microrna-221-222-in-patients-with-monoclonal-gammopathy-of-undetermined-significance-and-multiple-myeloma
#16
Suwen Yang, Wei Wang, Hong Jin, Yuhong Zhong, Xinyou Xie
Objective: To detect the expression of miR-221/222 in serum and plasma cells in patients with monoclonal gammopathy of undetermined significance(MGUS) and multiple myeloma(MM), and to explore the possibility of miR-221/222 as biomarkers in the diagnosis and prognosis predicting of MGUS and MM. Methods: Bone marrow and serum samples from 14 patients with newly diagnosed MGUS, 81 patients with newly diagnosed or relapsed MM and 10 controls were collected from Sir Run Run Shaw Hospital of Zhejiang University and Tongde Hospital of Zhejiang Province during January 2013 and December 2015...
May 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/27866585/plasma-cell-disorders
#17
REVIEW
Jorge J Castillo
Plasma cell disorders are benign, premalignant, and malignant conditions characterized by the presence of a monoclonal paraprotein detected in serum or urine. These conditions are biologically, pathologically, and clinically heterogeneous. There have been major advances in the understanding of the biology of these diseases, which are promoting the development of therapies with novel mechanisms of action. Novel agents such as proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies have gained approval in the United States and Europe for the treatment of plasma cell disorders...
December 2016: Primary Care
https://www.readbyqxmd.com/read/27804161/monoclonal-gammopathy-of-undetermined-significance-mgus-and-smoldering-myeloma-smm-a-practical-guide-to-management
#18
Nicola Maciocia, Ashutosh Wechalekar, Kwee Yong
Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma are precursor conditions of symptomatic multiple myeloma (MM). Diagnostic principles are aimed at excluding MM requiring therapy, other conditions associated with paraproteins that may require different management, and risk stratifying patients for the purposes of tailored follow-up and investigation. The International Myeloma Working Group have recently published a revised definition of MM, which singles out a small group of patients with smoldering multiple myeloma who are at very high risk of progression and organ damage; such patients are now included under the definition of MM and recommended to start anti-myeloma treatment...
November 2, 2016: Hematological Oncology
https://www.readbyqxmd.com/read/27775221/light-chain-podocytopathy-mimicking-recurrent-focal-segmental-glomerulosclerosis
#19
M A Khalighi, M P Revelo, J D Abraham, F Shihab, F Ahmed
Kidney injury related to paraproteinemia is common and typically occurs after the fourth decade of life in association with an underlying plasma cell dyscrasia or other lymphoproliferative disease. Kidney transplantation in paraprotein-related kidney disease can be successful in conjunction with treatment of the underlying hematopoietic process; however, when hematologic response to therapy is not achieved, recurrent kidney injury is frequently seen. We describe a young male patient who presented at the age of 23 years with end-stage kidney disease thought to be secondary to focal segmental glomerulosclerosis; this patient ultimately received two kidney allografts...
October 24, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27772927/immunotactoid-glomerulopathy-with-igm-positivity-and-associated-igm-paraprotein
#20
T Phillips, M Brown, M E Koina
No abstract text is available yet for this article.
February 2016: Pathology
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