IgE monoclonal gammopathy: A case report and literature review

Hejl, Connie; Mestiri, R.; Carmoi, T.; Bugier, Sarah; Chianéa, Denis; Renard, Claire-Angélique; Vest, Philippe

doi:10.1016/j.clinbiochem.2017.09.015

Cited by 14 publications

(22 citation statements)

References 51 publications

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“…The SPE in combination with serum FLC assay and IFE yields high sensitivity in the context of screening for MM and related plasma cell disorders ( 14 , 15 ). When a monoclonal peak consists only of light chains, an IFE specific for IgD and IgE is required ( 5 , 22 , 23 ). In our case, the recommended screening procedure to detect monoclonal gammopathies had been applied.…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…Monoclonal gammopathy of undetermined significance is present in about 4% of Caucasians over the age of 50, with a 1% average annual risk of progression to malignant MM ( 4 ). The IgE-producing variant is the rarest sub-type of MM accounting for less than 0.1% of MM cases ( 5 ). About 60 cases have been described in the literature so far highlighting that IgE MM seems to have the poorest outcomes among heavy chain subtypes of MM with a mean survival time of 16 months versus 30 months for non IgE MM ( 6 ).…”

Section: Introductionmentioning

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%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

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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“…Dear Editors, Immunoglobulin E (IgE) monoclonal gammopathy is the rarest plasma cell disorder (<0.1%). 1 The first report was described in 1967, and only 63 cases of IgE gammopathy have been published in literature. 1 Therefore, there are very little data about this disease.…”

Section: Ige Monoclonal Gammopathy: the Clinical Relevance To Performmentioning

confidence: 99%

“…1 The first report was described in 1967, and only 63 cases of IgE gammopathy have been published in literature. 1 Therefore, there are very little data about this disease. [1][2][3] In this study, we reported two cases of IgE monoclonal gammopathy, which represent around 0.01% of all monoclonal component identified at the San Gerardo Hospital, Monza (Italy), from 2005 to 2019.…”

Section: Ige Monoclonal Gammopathy: the Clinical Relevance To Performmentioning

confidence: 99%