IgM MGUS associated with anti-MAG neuropathy: a single institution experience

Talamo, Giampaolo; Mir, Mohammad Amin; Pandey, Manoj K.; Sivik, Jeffrey; Raheja, Divisha

doi:10.1007/s00277-014-2294-7

Cited by 20 publications

(15 citation statements)

References 41 publications

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“…However, clinically, IgM monoclonal gammopathy is less common than the IgG and IgA types. 13 There are few reports on laboratory serum markers for differential diagnosis IgM monoclonal [16][17][18][19] Of the 66 WM patients examined in our study, the kappa/lambda ratio (К/λ) was 3.13 (50/16). Of the 51 patients with MGUS, the К/λ was 1.55 (31/20); this value is similar to that observed in previous studies.…”

Section: Discussionmentioning

confidence: 88%

Serum markers in the differential diagnosis of Waldenstrom macroglobulinemia and other IgM monoclonal gammopathies

Zou

Yang

Liao

et al. 2018

Clinical Laboratory Analysis

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Background IgM monoclonal gammopathy can be present in a broad spectrum of diseases. We evaluated the value of serum markers in the differential diagnosis of Waldenstrom macroglobulinemia (WM) and other types of IgM monoclonal gammopathies. Methods We included patients who were first admitted to hospital and identified as having IgM monoclonal gammopathy by serum immunofixation electrophoresis (sIFE). We evaluated basic clinical features, sIFE, diagnosis, and serum markers. Furthermore, we applied the receiver operating characteristic (ROC) curve to analyze the differential diagnosis value of serum markers for WM. Finally, we used logistic regression and ROC curve to analyze the differential diagnosis value of multimarker combinations to identify WM. Results IgM monoclonal gammopathy was most frequently found in patients with Waldenstrom macroglobulinemia, followed by monoclonal gammopathy of undetermined significance (MGUS), B‐cell non‐Hodgkin Lymphoma (B‐NHL), and multiple myeloma (MM). Serum markers showed significant differences among the four diseases. The diagnostic markers LDH, IgM, IgG, IgA, and serum light chain К had higher diagnostic efficiency. Among these markers, serum IgM provided the highest diagnostic efficiency. Additionally, the combined use of all five serum markers provided the most effective diagnosis. Conclusions The five serum markers, LDH, IgM, IgG, IgA, and К, each yielded a specific efficacy in differential diagnosis of WM. The single marker with the highest diagnostic efficiency was the serum IgM level. However, a combination of multiple serum markers was better than the use of a single marker in diagnosing WM. The combined use of all five serum markers provided the most effective diagnosis, with an AUC of .952 and sensitivity and specificity of 87.8% and 86.9%, respectively.

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Section: Discussionmentioning

confidence: 88%

Serum markers in the differential diagnosis of Waldenstrom macroglobulinemia and other IgM monoclonal gammopathies

Zou

Yang

Liao

et al. 2018

Clinical Laboratory Analysis

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“…Besides specific affinity for autoantigens participated in coagulation process, antibody activities of monoclonal immunoglobulin reported in cases were highly varied, like IgM acting as anti-myelin-associated glycoprotein (MAG) antibodies in MGUS associated with peripheral neuropathy [12], IgM and IgG against transferrin in MGUS associated with transferrin-immune complex disease (TICD) [13] and IgG as antibodies against the CUB1-2 domains of ADAMTS13 in a MGUS patient associated with thrombotic thrombocytopenic purpura [14]. The existence of monoclonal immunoglobulin with specific affinity could also be found in multiple myeloma [15].…”

Section: Discussionmentioning

confidence: 99%

IgMk paraprotein from gammopathy patient can bind to cardiolipin and interfere with coagulation assay: a case report

Yin

Teng

et al. 2017

BMC Immunol

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BackgroundThe monoclonal gammopathies are a group of plasma-cell proliferative disorders characterized by the secretion of monoclonal immunoglobulin (M protein or paraprotein). Some rare cases have revealed the specific affinity of paraprotein as autoantibody. Here we report a patient with monoclonal gammopathy of undetermined significance (MGUS) accompanied by a remarkable increase of anticardiolipin antibody (aCL) and an extensively decreased coagulation factor activity, however, without any clinical signs of antiphospholipid syndrome (APS) and bleeding.ResultsOur further investigation indicated that IgMκ paraprotein of this patient possessed an antibody activity against phospholipids so as to bind to cardiolipin and interfere with coagulation assay in vitro.ConclusionsThis case might be indicative that an abnormality of coagulation tests, disturbed by IgMκ paraprotein, does not predict a risk of bleeding in this patient.

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“…MAG-Abs detection is preferentially performed with ELISA, which produces quantitative results useful for monitoring the disease. Other tests, including Western or line blot, and TBAs are available, but they show lower accuracy (63,64).…”

Section: Mag Antibodiesmentioning

confidence: 99%

Autoantibody Diagnostics in Neuroimmunology: Experience From the 2018 Italian Neuroimmunology Association External Quality Assessment Program

et al. 2020

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Results: Three-quarter of the tests were commercial. Median accuracy for the laboratories was 75% (range 50-100). In 8/10 schemes, at least one sample provided discrepant results. Inter-laboratory "substantial agreement" was found in 6/10 schemes (AChR, MuSK, MAG, AQP4, MOG, and NS-Abs), whereas the worst agreements regarded OCBs and ganglioside-Abs. Both commercial and in-house assays performed better in experienced laboratories.Conclusions: Assays could be divided in (a) robust commercial tests with substantial inter-laboratory agreement (MAG-Abs; AChR-and MuSK-Abs); commercial/"in-house" tests with (b) partial inter-laboratory agreement (AQP4-Abs, MOG-Abs, NS-Abs, Gastaldi et al.AINI 2018 EQA Program ICN-Abs), and (c) with large inter-laboratory disagreement (OCBs, ganglioside-Abs). This real-life snapshot of the neuroimmunology test performances highlights shortcomings attributable to technician-dependent performances, assay structural limitations, and errors in test interpretations.

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IgM MGUS associated with anti-MAG neuropathy: a single institution experience

Cited by 20 publications

References 41 publications

Serum markers in the differential diagnosis of Waldenstrom macroglobulinemia and other IgM monoclonal gammopathies

Serum markers in the differential diagnosis of Waldenstrom macroglobulinemia and other IgM monoclonal gammopathies

IgMk paraprotein from gammopathy patient can bind to cardiolipin and interfere with coagulation assay: a case report

Autoantibody Diagnostics in Neuroimmunology: Experience From the 2018 Italian Neuroimmunology Association External Quality Assessment Program

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