Monoclonal Gammapathy

The monoclonal gammapathy indicates an anomaly translated by an abnormal quantity of gammaglobulines i.e. by an high rate of a Immunoglobuline S particular.

Frequency and ground

This anomaly is found in nearly 3% of the population of more than 50 years in an American study. It reaches more than 5% of the patients of more than 70 years. It is more frequent at the man. The immunoglobulin concerned is generally of type IgG (69%)

Physiopathology

Within the framework of the Cancer S, the monoclonal gammapathy is a homogeneous production of a gammaglobuline of only one type by a clone of Plasmocyte S malignant.

The gammapathy expresses the exaggerated production of a substance which finds in the Sang like a tumoral Marqueur reflecting the volume of the cancer cells and making it possible to supervise it during the treatment.

Diagnosis

Proportioning and electrophoresis of immunoglobulins.

An analysis of the Sérum in blood makes it possible to detect this anomaly (fortuitously during a gift of plasma and not during a gift of blood). To establish a final diagnosis, it is necessary to make a Myélogramme and a Radiographie (to seek the presence of géode: osseous gaps)

Etiology S

The principal malignant monoclonal gammapathies are
  • the multiple Myélome (with immuno-globulines G and A),
  • the Maladie of Waldenström (with immunoglobulins M),
  • some Lymphome S.

A discrete monoclonal gammapathy can be a benign monoclonal gamapathy , not requiring any treatment but a regular monitoring because being able to translate for a malignant gammapathy beginner. The discrete monoclonal gammapathies are to be regarded as being gammapathies pre-malignant (MGUS). And that even if no argument exists to affirm the systematic transformation into cancer of a benign monoclonal gammapathy.

Complications

The disease will be all the more serious for the old or young patients.

All the monoclonal gammapathies can become complicated immunoglobulinic Amylose.

See too

References

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