Paraproteins, benign or malignant?

Abstract

hDIiN.L 699and delivery in an ambulance-do result in impaired academic performance among children at ordinary schools, it seems unlikely that they exert more than a small influence on the intellectual development of children exposed to them. The distributions of scores of affected children were unimodal (Tables VI and XI) and therefore provided no evidence of a substantial group of children whose development was greatly impaired; and there were only small differences in the mean scores of affected and unaffected sibs. A previous analysis of the relation between obstetric complications and subnormal intelligence (an I.Q. below 75), based on the same obstetric data as the present analysis, revealed an association between educational subnormality and both precipitate labour and delivery in the absence of a qualified attendant (Barker, 1966). But neither of these complications seems to be associated with impaired performance within the normal range of intelligence.The mean V.R. scores of children delivered instrumentally or by caesarean section were higher than those of the population and of their unaffected sibs. It seems reasonable to suppose that a child born by caesarean section may avoid cerebral damage sustained in a normal delivery; but it is difficult to explain the association between instrumental delivery and raised V.R. scores. The data are, however, too complex to justify the conclusion that instrumental delivery will improve school performance.The finding that the mean V.R. score in the population declines with increasing birth rank (Table II) confirms numerous previous observations of the negative correlation between fraternity size and measured intelligence. But this inquiry has also shown that within fraternities there is an average fall of 1.0 in V.R. score with each unit increase in birth order. SummayBirth records of 50,000 children were linked with records of school performance at the age of 11. Twins and triplets showed marked impairment, and were excluded from this study. The verbal reasoning (V.R.) scores of single-born children exposed to obstetric complications were compared with those of the population and of their sibs. The results suggested that impaired performance was associated with only five of the obstetric complications studied: a short gestation period, a prolonged gestation period, toxaemia, occipito-posterior presentation, and delivery in an ambulance. In no case was the impairment very marked. Within fraternities there was a fall in average V.R. score with increasing birth rank.

Multiple myeloma in alcoholic liver cirrhosis.

“…It might be concerned in the relatively short survival of patients with liver cirrhosis, because the clinical appearance of myeloma takes a time (Hobbs 1967;Salmon and Dune 1975). In this paper, we reported a case of myeloma with alcoholic liver cirrhosis.…”

Significance of M-components in Plasma Cell Myeloma and Related Disorders

“…In this regard two points of view have been presented by several authors. In one of them the two conditions are separated clinically10, 16,17,35; that is, malignant lymphoma with M-components is considered to be secondary monoclonal gammopathy.…”

Detection of Bence-Jones protein in practice

“…While one original study indicated that the presence of BJP, detected at a sensitivity of 10 mg/L, was almost always associated with a B-cell malignancy, 7 other work reported that values less than 60 mg/L could be observed in benign monoclonal gammopathies. 24 As B-cell clones usually synthesize an excess of light chains 25 it might be predicted that all serum monoclonal components would be accompanied by BJP 25 provided the sensitivity for detection is lowered suf®ciently.…”

“…5,6 Secondly, it was observed in early studies that the presence of BJP was highly predictive of a malignant monoclonal gammopathy. 7,8 Despite the occasional reports of cases classi®ed as monoclonal gammopathy of undetermined signi®cance excreting BJP of up to 1 g/24 h, 9 the presence of BJP is today regarded as central to the initial assessment of the patient presenting with a serum monoclonal component. 2 It is also important in assessing prognosis and directing subsequent management of a patient with a serum monoclonal component in whom the initial diagnosis is uncertain.…”