Monoclonal gammopathy of unknown significance and malignant paraproteinemia in Hong Kong.
Am J Clin Pathol
; 106(4): 449-56, 1996 Oct.
Article
em En
| MEDLINE
| ID: mdl-8853031
ABSTRACT
The incidence of multiple myeloma is lower in Southeast Asia than in the West. However, there are few reports on the overall incidence of paraproteinemia and its disease-associations in the Chinese. Therefore, the authors have correlated the laboratory features with the eventual clinical diagnosis in patients with paraproteinemia in a Hong Kong general/teaching hospital. Over 18 months, 1,600 patients were investigated for the presence of paraproteinemia. Paraproteinemia was detected in 157 (10%) patients. In 11 patients, investigations could not be completed. The remaining 146 patients were subjected to detailed clinical, radiologic, and laboratory investigations. Eighty-seven (59.6%) had monoclonal gammopathy of unknown significance (MGUS), 44 (30.1%) myeloma and 15 (10.3%) other lymphoproliferative disorder (LPD). There was no significant difference in the paraprotein concentration, frequency of hypogammaglobulinemia of Bence Jones proteinuria (BJP) or concentration of nonparaprotein immunoglobulin (Ig) between the myeloma and LPD groups. The overall kappalambda light chains ratios were 2.9, 1.6 and 3.3 in the MGUS, MM and LPD groups, respectively. Polyclonal Ig elevation was rare with myeloma (4.5%) but was detected in 33% of patients with LPD (P < .02) and 40% of those with MGUS (P < .0001). Biclonal (and one triclonal) gammopathy was detected in 11.5% of patients with MGUS, 11% with LPD and 4.5% with myeloma. In the MGUS group, infection was the commonest associated clinical disorder (29.3%). Moreover, 70% of patients with biclonal gammopathy and MGUS had an infection. Five of 15 patients with LPD had a T-cell malignancy, including 3 lymphomas and 2 large granular cell leukemias. Only one patient had primary systemic amyloidosis. It is concluded that the high frequency of biclonality and its association with infection, of paraproteinemia in association with T-cell malignancy and of kappa light chains in the MGUS and LPD groups are at variance with reports from the West and probably reflect local differences.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Paraproteinemias
Tipo de estudo:
Diagnostic_studies
/
Incidence_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
/
Aged
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Aged80
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Child
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Child, preschool
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Am J Clin Pathol
Ano de publicação:
1996
Tipo de documento:
Article