"Benign" monoclonal IgE gammopathy.

Ludwig, Heinz; Vormittag, W

doi:10.1136/bmj.281.6239.539

Cited by 13 publications

(4 citation statements)

References 16 publications

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“…In a recent literature review of 63 IgE MM cases, Hejl et al observed that IgE MM has a more aggressive clinical course than others MM subtypes ( 5 ). However, IgE monoclonal gammopathies do not necessarily imply malignant evolution and benign courses are indeed possible ( 5 , 25 , 26 ). The IgE MM patients mean age at the time of diagnosis was 68 years (range: 28 – 87 years) with a male predominance (sex ratio M/F: 1.26).…”

Section: Discussionmentioning

confidence: 99%

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A case of IgE myeloma transformed into IgE-producing plasma cell leukaemia

Galakhoff

Leven

Eveillard

et al. 2020

Biochem. med. (Online)

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This is a case report of a challenging diagnosis of IgE monoclonal gammopathy of undetermined significance, which transformed into myeloma, then transformed into IgE-producing plasma cell leukaemia in a 71-year-old male who was followed in Brest, France, from 2015 to 2019. The IgE-producing variant is the rarest sub-type of multiple myeloma, and plasma cell leukaemia is considered to be the rarest and the most aggressive of human monoclonal gammopathies. In November 2015, hypogammaglobulinemia was detected during a systematic check-up. A kappa light chain monoclonal gammopathy was first diagnosed due to an increase of the free kappa/lambda light chains ratio. No monoclonal immunoglobulin was detected by either serum protein electrophoresis (Capillarys 2, Sebia, Issy-les-Moulineaux, France) or immunofixation (Hydrasys 2, Sebia, Issy-les-Moulineaux, France). In June 2018, a blood smear led to the diagnosis of plasma cell leukaemia. A monoclonal peak was detected and identified as IgE-kappa. Analysis of an archival sample taken three years earlier, revealed the presence of a monoclonal IgE, which had been missed at diagnosis. Chemotherapy with bortezomib and dexamethasone was introduced. The patient survived 10 months after the diagnosis of leukaemia. This case shows that an abnormal free light chain ratio should be considered as a possible marker of IgE monoclonal gammopathy even in the absence of a solitary light chain revealed by immunofixation. In addition, the use of an undiluted serum may increase the sensitivity of the immunofixation for the detection of IgE monoclonal gammopathies compared to the 1:3 dilution recommended by the manufacturer.

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Section: Discussionmentioning

confidence: 99%

“…The International Myeloma Working Group provides recommendations for primary PCL treatment ( 26 ). To our knowledge, there is no standardized recommendation for the management of sPCL.…”

Section: Discussionmentioning

confidence: 99%

A case of IgE myeloma transformed into IgE-producing plasma cell leukaemia

Galakhoff

Leven

Eveillard

et al. 2020

Biochem. med. (Online)

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“…Most of the reported cases have been accompanied by complications that are rarely seen with other types of myeloma. Also benign IgE monoclonal gammopathies have been reported (22,31). Biclonal (7,13,24) and triclonal gammopathies (19,24) have been described, where IgE is one component.…”

Section: Introductionmentioning

confidence: 98%

IgE myeloma: a case presentation and a review of the literature

Kairemo

Lindberg

Prytz

1999

Scandinavian Journal of Clinical and Laboratory Investigation

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In the literature, fewer than 40 cases of IgE myeloma have been described. We report the first Norwegian case, an 80-year-old man presenting with progressive weakness, dyspnea and dizziness. With the exception of hypersedimentation, routine chemistry values were within reference limits. Plasma cells were not observed in the peripheral blood. Serum protein electrophoresis showed a monoclonal protein in the gammaglobulin fraction. Immunofixation confirmed the presence of an IgE kappa monoclonal protein. A bone marrow biopsy revealed an interstitial and nodular infiltration of abnormal plasma cells comprising 40% of nucleated cells present. Skeletal roentgenograms of this patient showed osteolytic lesions in the skull and in the left pubic arc. The findings for this patient were compared with the previous reports of IgE myeloma.

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“…The IgE‐secreting subtype of multiple myeloma, first reported in 1967, is an extremely rare disease, representing only 0.01% of all cases (1, 6). Including our patient, originally reported in 1984 (7), there have been 43 cases reported (8), along with one case of IgE monoclonal gammopathy of uncertain clinical significance (MGUS) (9).…”

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confidence: 97%

Low IgE monoclonal gammopathy level in serum highlights 20‐yr survival in a case of IgE multiple myeloma

Hayes

Carey

Krauss

et al. 2007

European J of Haematology

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This report describes the diagnosis, follow-up, and problems measuring serum immunoglobulin E (IgE) levels in a case of IgE myeloma with 20-yr survival. Serum and urine protein electrophoresis, immunofixation, and the N Latex IgE test were used to characterize the monoclonal proteins. The diagnosis of multiple myeloma in a 56-yr-old man was based on 5.4 g/24 h of monoclonal free lambda chain in urine and bone marrow findings of 23.5% plasma cells (19% mature and 4.5% atypical). IgE lambda monoclonal protein in serum measured 506,000 microg/L (210 833 IU/mL). The lack of other clinical findings of multiple myeloma places this case in the category of 'smoldering or indolent myeloma'. Measurement of serum IgE levels was complicated by the need to predilute serum to avoid antigen excess. Following chemotherapy, the patient went into clinical remission, eventually dying of complications of emphysema. This case expands the recognized clinical spectrum of IgE multiple myeloma.

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"Benign" monoclonal IgE gammopathy.

Cited by 13 publications

References 16 publications

A case of IgE myeloma transformed into IgE-producing plasma cell leukaemia

A case of IgE myeloma transformed into IgE-producing plasma cell leukaemia

IgE myeloma: a case presentation and a review of the literature

Low IgE monoclonal gammopathy level in serum highlights 20‐yr survival in a case of IgE multiple myeloma

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