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Clinical Problems of IgM Monoclonal Gammapathies


Authors: T. Pika 1;  P. Flodr 2;  M. Novák 3;  P. Lochman 4;  P. Látalová 2;  J. Minařík 1;  V. Ščudla 1
Authors‘ workplace: III. interní klinika – NRE, LF UP a FN Olomouc 1;  Ústav klinické a molekulární patologie, LF UP a FN Olomouc 2;  Hematoonkologická klinika, FN Olomouc 3;  Oddělení klinické biochemie, FN Olomouc 4
Published in: Klin. Biochem. Metab., 22 (43), 2014, No. 2, p. 61-64

Overview

Monoclonal gammopathies associated with presence of IgM paraprotein form a heterogeneous group of diseases. Monoclonal gammopathy of undetermined significance (MGUS) of IgM type presents a potentially malignant condition with a risk of neoplastic transformation into a different type of lymphoproliferative disorder than the forms of MGUS with other paraprotein isotypes. Most often it transforms into Waldenström´s macroglobulinemia, which is a lymphoproliferative disorder (lymphoplasmocyte lymphoma) with the production of IgM paraprotein. The disease is relatively indolent, requiring systemic treatment only in the case of significant tumor clone burden together with the presence of symptoms associated with high levels or certain qualitative characteristics of IgM protein. IgM multiple myeloma and IgM AL amyloidosis are rare disorders in the differential diagnostics of IgM paraproteinemia. Differentiation of individual conditions can be difficult, and requires the cooperation of several specialists.

Key words:
IgM, monoclonal gammopathy of undetermined significance, multiple myeloma, amyloidosis, Waldenström´s macroglobulinemia.


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