No abstract

Monoclonal gammopathy reflects a serological disorder suggesting a plasma cell dyscrasia or a B-cell abnormality. However, it may occasionally be encountered as a transient manifestation in the course of several diseases including infections. This is the first reported case of a transient monoclonal gammopathy IgG lambda light chain associated with a Staphylococcus aureus infection that was complicated with renal abscess and vertebral spondylodiscitis in a previously healthy 68-year-old male. We observed a complete resolution of the gammopathy within three months of medical treatment before the entire restoration of all clinical and laboratory findings. Many invasive and cost-intensive diagnostic procedures had preceded the exclusion of a malignancy. The clinical significance and the exact pathogenesis of transient monoclonality are poorly understood and remain a matter of speculation.

Euglycemic ketoacidosis is defined by the triad of high anion gap acidosis, increased plasma ketones, and the absence of hyperglycemia. Apart from diabetes mellitus, the disorder may occur in prolonged fasting, excessive alcohol consumption, pregnancy, and inborn errors of metabolism. Here, we highlight the diagnosis of euglycemic ketoacidosis in a pediatric nondiabetic patient with spinal muscular atrophy (SMA) type 1 (Werdnig–Hoffmann disease), who, subsequently to her postoperative admission to the intensive care unit following a spinal surgery, developed high anion gap metabolic acidosis. We discuss the pathophysiology of acid-base disorders in SMA, along with the glucose and fatty acids metabolism, the necessary knowledge for medical practitioners.