IgM Paraproteinemisi ile İlişkili Hastalıkların Spektrumu

Abstract

Diseases associated with IgM monoclonal gammopathy range widely from silent lesions to diseases that can be aggressive and fatal, and this rare condition is often misdiagnosed because of its rarity and heterogeneity. Our aim in this study is to determine the frequency of encountering diseases associated with IgM paraproteinemia and to develop awareness in differential diagnosis. Our study included 48 patient with IgM paraproteinemia detected between 26.07.07 and 09.08.19 in Hacettepe University Hospitals with the presence of IgM type MG detected by serum immunofixation methods and / or monitored between 2003 and 2019 by scanning from the Clinical Biochemistry Laboratory database. 17 of the patients were female (35.42%), 31 were male (65.58%), and the median age was 73 years (age range 40-92 years). 17 of the patients were female (35.42%), 31 were male (65.58%), and the median age was 73 years (age range 40-92 years). In terms of final diagnoses, 23 patients (47.9%) had Waldenström's macroglobulinemia (WM), 12 patients (25%) indeterminate Non-Hodgkin lymphoma (NHL), 8 patients (16.67%) monoclonal gammopathy (MGUS), 2 patients (4.2%) had chronic lymphocytic leukemia (CLL), 1 patient (2.1%) had primary amyloidosis, 1 patient (2.1%) had cryoglobulinemia. The average follow-up time was 57.1 months. During the follow-up period, 33.33% (16 patients) of the patients died, 66.67% (32 patients) were alive. 78.3% of the patients diagnosed with Waldenström's macroglobulinemia, which is the most common diagnosis, were alive. Mortality rate was 50% in patients diagnosed with chronic lymphocytic leukemia and lymphoma. After 10 years of follow-up, 60% survival was observed in patients with WM. Consequently, monoclonal protein is recognized for many years. When monoclonal gammopathies are discussed, most researchers think of multiple myeloma first, but MGUS and WM are other common causes of these disorders.IgM monoclonal proteins constitute about 15% of monoclonal proteins and contrary to what is known, it is more common in diseases with malignant character such as WM and Lymphoma than benign MGUS.And these patients, including those diagnosed with MGUS, should be under surveillance indefinitely.