Retrospective study of monoclonal gammopathies detected in the clinical laboratory of a Spanish healthcare district: 14-year series

Bergón, Enrique; Miravalles, Elena

doi:10.1515/cclm.2007.029

Cited by 15 publications

(11 citation statements)

References 13 publications

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“…These two reports illustrate the difficulty in generalizing across studies that use different methodologies or case definitions: the Swedish study was based on IEP rather than IFE for identification of IgM, and the Dutch study employed a restricted definition of MGUS compared with many other reports. On the basis of a limited number of reports, IgM MGUS appears to be substantially less frequent in Eastern Europe (38), Greece (39), and Israel (29) and intermediate in southern European countries such as Spain (41) and Italy (37). Geographical variation also appears within populations of western European descent (42, 44, 47).…”

Section: Prevalence Of Igm Mgus In Various Populationsmentioning

confidence: 99%

Magnetic resonance imaging measures of brain atrophy in multiple sclerosis

Anderson

Fox

Miller

2006

Magnetic Resonance Imaging

103

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Magnetic resonance imaging (MRI) has been widely used to diagnose and monitor multiple sclerosis (MS). Although MRI-visible lesions are a key feature of MS, they are thought to correlate poorly with clinical progression. Neurodegeneration is increasingly being recognized as an important factor in the pathogenesis of MS, and MRI measures of brain atrophy have been suggested as surrogate markers of neuroaxonal loss and disease progression. This pathology may be more relevant to the progression of disability than focal inflammation. A number of MRI-based methods have been developed for the measurement of global and regional brain atrophy. Natural-history studies of MS and clinically isolated syndromes suggestive of MS have observed atrophy in these subjects above that seen in controls, over periods ranging from three months to years. Brain atrophy has also been incorporated as an outcome measure in therapeutic trials of disease-modifying treatments. This paper considers neuroaxonal loss and the pathological basis of brain atrophy, methods developed to quantify brain atrophy, the findings of natural-history and therapeutic studies, the relationship of brain atrophy to disability and cognition, and the future research directions and clinical applications of brain atrophy measurements. MAGNETIC RESONANCE IMAGING (MRI) is established as a key investigatory tool for diagnosing multiple sclerosis (MS), and is increasingly used to monitor disease progression and provide outcome measures in therapeutic trials. Conventional MRI measures of lesions, representing inflammation and demyelination, have been found to correlate poorly with progression of disability. Postmortem and quantitative MR studies have confirmed that widespread abnormalities occur in normal-appearing brain tissue, and the role of axonal damage and neurodegeneration in the pathogenesis of MS has been highlighted. Neuroaxonal degeneration is irreversible and is likely a relevant mechanism of permanent disability. Measurement of tissue loss (atrophy) has been suggested as a marker of this pathology and may be a better marker of disease progression than conventional lesion measures. A number of MRI-based techniques used to measure central nervous system (CNS) atrophy in vivo have shown progressive brain atrophy above that seen in normal aging in subjects with clinically isolated syndromes (CIS) and MS. Such atrophy has been associated with disability progression. As a result, atrophy measures have been adopted as secondary outcomes in a number of trials of diseasemodifying drugs. This paper expands and updates the review by Miller et al (1) and addresses the pathology behind axonal damage, methods developed to measure brain atrophy, the findings of clinical studies that monitored brain atrophy, and the role of atrophy measures in MS research and clinical applications. While important studies have documented atrophy of the spinal cord and optic nerves in MS, this review will focus on brain atrophy. EVIDENCE AND MECHANISMS OF NEUROAXONAL DEGENERATION IN MSMicrosc...

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Section: Prevalence Of Igm Mgus In Various Populationsmentioning

confidence: 99%

Magnetic resonance imaging measures of brain atrophy in multiple sclerosis

Anderson

Fox

Miller

2006

Magnetic Resonance Imaging

103

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“…This approximate 100:1 ratio in the population generally corresponds to Brought to you by | University of Queensland -UQ Library Authenticated Download Date | 6/23/16 2:26 AM the reported progression rate of MGUS to myeloma and related conditions. However, reports on the disease spectrum seen at healthcare institutions indicate that MGUS contributes between 51% and 54%, the myeloma group of diseases 25%-33% and light chain amyloidosis 1%-11% of the monoclonal gammopathy caseload [5,10]. This 1.6-2: 1 ratio of MGUS to myeloma is in contrast to that suggested by the population prevalences and probably reflects the effect of targeted investigations based on clinical presentation on yield, as opposed to indiscriminate population based screening.…”

Section: Clinical Considerationsmentioning

confidence: 84%

Screening immunofixation should replace protein electrophoresis as the initial investigation of monoclonal gammopathy: Point

Pretorius

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:The reliable detection of paraprotein in serum and urine is the primary purpose of electrophoretic procedures in clinical laboratories. Screening immunofixation electrophoresis (sIFE) employs a single application of antisera directed against heavy and light chains that facilitates the detection of paraproteins that migrate in the non-γ region or that are below the detection limit of protein electrophoresis. These paraproteins that are missed by routine electrophoresis occur in up to 27.3% of newly investigated and 13.6% of monitored patients. Small paraproteins missed by conventional electrophoretic techniques are clinically important in the diagnosis and monitoring of malignant plasma and B-cell disorders. The superior diagnostic performance of sIFE makes it suitable as the initial laboratory procedure to investigate paraproteins in complex serum and urine matrices.

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Section: S93mentioning

confidence: 99%

“…Several early studies were large surveys in clinically defined populations, such as blood donors (42,44,46) that were pivotal in identifying the subgroup of monoclonal gammopathy that was ultimately designated MGUS. Most are series based on patients referred to tertiary care centers for electrophoretic studies during a diagnostic evaluation because of a known or suspected M-protein (29,30,39,41). Others evaluate defined population of interest, such as atomic bomb survivors (27) or elderly residents in a retirement home (31,34).…”

Section: S93mentioning

confidence: 99%

Prevalence, clinical aspects, and natural history of IgM MGUS

McMaster

Landgren

2010

Cytometry Part B Clinical

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Results: There appears to be marked heterogeneity in the prevalence of IgM MGUS across populations. However, studies have varied in definition, design, laboratory methods, and endpoints. IgM MGUS differs from non-IgM MGUS in certain respects, including prevalence across racial groups, rate of progression, and pattern of malignant outcomes. There are limited data regarding the coincident occurrence of IgM MGUS and MBL.Conclusions: Future studies incorporating both protein electrophoresis and flow cytometry are needed to define the underlying spectrum and causes of precursor development, risk factors for progression, and markers that distinguish low-and high-risk precursor patients. Published

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Retrospective study of monoclonal gammopathies detected in the clinical laboratory of a Spanish healthcare district: 14-year series

Cited by 15 publications

References 13 publications

Magnetic resonance imaging measures of brain atrophy in multiple sclerosis

Magnetic resonance imaging measures of brain atrophy in multiple sclerosis

Screening immunofixation should replace protein electrophoresis as the initial investigation of monoclonal gammopathy: Point

Prevalence, clinical aspects, and natural history of IgM MGUS

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