Monoclonal gammopathy in chronic active hepatitis

Abstract

-Immunoelectrophoresis was performed in 31 of 272 patients with chronic active hepatitis (CAH) because of an M-spike component (seven patients, 2.6%) or hypergammaglobulinemia (24 patients) revealing a monoclonal gammopathy (MG) in 11 patients. In addition, 50 randomly selected patients with CAH and no evidence for an M-spike component were tested by immunoelectrophoresis. In 13 patients (26%), an MG was found. The mean age of the 24 patients with MG was 57.4 years (range: 23-76). HBsAg was present in nine patients (37.5%), no HBV-marker was detected in ten patients (41.7%). The immunoglobulin class of MG was IgG in ten patients (41.7%), IgA in one patient (4.2%) and IgM in 11 patients (45.8%). In two patients, Bence Jones protein was found in either serum or urine. In only one patient was the MG associated with multiple myeloma, whereas none of the other 23 patients developed a malignant lymphoproliferative disease within the median observation period of 6 years. We conclude that there is an unexpectedly high prevalence of benign MG in patients with CAH.

Risk of multiple myeloma and monoclonal gammopathy of undetermined significance among white and black male United States veterans with prior autoimmune, infectious, inflammatory, and allergic disorders

“…However, reports linking MM with a prior diagnosis of infection with herpes zoster 12,16,34 or hepatitis C virus (HCV) [35][36][37] have been inconsistent. Conversely, a high prevalence of MGUS was noted in a series of patients with chronic active hepatitis, 38 and a 30% increased risk of MGUS was noted among a cohort of patients with HCV infection. 35 The significantly elevated risk of greater than 3.5 for patients diagnosed with poliomyelitis 10 or more years prior to MM is intriguing and unlikely due to delayed diagnosis of neurologic findings.…”

Primary sclerosing cholangitis complicating plasma cell dyscrasia (PCD): remission of PCD following liver transplant

“…Other chronic liver diseases such as chronic active hepatitis (4), autoimmune hepatitis (5), primary biliary cirrhosis (6) have been documented in association with MM. Dramatic benefit of liver transplant on MM in our case may suggest similar benefit to those with other chronic liver diseases complicating MM.…”

“…Associations of plasma cells dyscrasia (PCD) with chronic liver and biliary tract diseases such as chronic active hepatitis (4), autoimmune hepatitis (5), primary biliary cirrhosis (6) have been well described. However, association of PSC and multiple myeloma (MM) has never been reported.…”

Geographic Prevalence Patterns and Modifiable Risk Factors for Monoclonal Gammopathy of Undetermined Significance

“…Meanwhile, less is known about global geographic patterns in the prevalence of MGUS. The prevalence of MGUS is likely population-specific and highly dependent on the composition and interaction of the modifiable (medical, socioeconomic, and environmental) and non-modifiable (demographic) risk factors affecting the individuals in each population [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Specifically, race, ethnicity, and increasing age are major non-modifiable risk factors for MGUS [26].…”