Generalized Discoid Lupus Erythematosus With Benign Monoclonal Gammopathy

Abstract

This paper presents the case of a patient with generalized discoid lupus erythematosus. During the past 25 years the patient has developed moderate systemic symptoms including leukopenia, anemia, elevated erythrocyte sedimentation rate and decreased serum complement. In the last 7 years, the serum γ‐globulin level has become conspicuously elevated, revealing a sharp monoclonal pattern. A M‐bow was detected in the IgG‐ and K‐chain precipitin arcs in immunoelectrophoresis. IgG type monoclonal gammopathy was confirmed, while the serum IgM level was decreased. No symptom suggesting the presence of multiple myeloma has ever been demonstrated by repeated bone X‐ray and the bone‐marrow examinations. The monoclonal gammopathy was well correlated with the intensity of cutaneous deteriolation and general symptoms.

Discoid lupus erythematosus and monoclonal gammopathy

“…Macroglobulinaemia (Abdou & Abdou, 1974) and cryoglobulinaemia (Chorazak, 1958;Gentele, Lagerholm & Lodin, 1959;Nelson, 1959) have been previously described in patients with DLE, but reports of monoclonal gammopathy are rare. A recent report from Japan described a 56-year-old man with generalized DLE, anaemia, decreased total haemolytic complement, and a benign IgG K monoclonal protein that remained stable for 7 years (Ueki, 1979). Feuerman & Halevy (1977) described a 64-year-old woman with lupus erythematosus profundus (Kaposi-Irgang) and a benign IgG k monoclonal protein who had a follow-up of more than 4 years.…”