Author/Editor		Mlakar, Uroš; Preložnik-Zupan, Irena
Title		Monoklonski imunoglobulin nedoločenega pomena
Translated title		Monoclonal gammopathy of undetermined significance
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 69, št. 11
Publication year		2000
Volume		str. 753-6
Language		slo
Abstract		Background. The term monoclonal gammopathy of undetermined significance (MGUS) denotes the presence of a monoclonal immunoglobulin in patients without evidence of multiple myeloma, macroglobulinaemia, amyloidosis or other related diseases. MGUS is quite frequent and its incidence is increasing. In addition to its common occurrence, its importance is obviously related to the fact that it may evolve toward multiple myeloma and related diseases. Methods. In the paper, we analysed the patients with MGUS who were diagnosed over a period of ten years at the Department of Haematology, University Medical Centre Ljubljana. The diagnostic criteria for MGUS were:serum monoclonal immunoglobulin <30 g/L, monoclonal immunoglobulin proteinuria<1g/day, bone marrow plasma cells,10%; absence of bone lesions, no symptoms of multiple myeloma or related diseases. Results. Over a period of 10 years, MGUS was diagnosed in 196 patients. The number of cases increased steeply in the last years of the study period. The male-to-female ratio was 83:113. The median age of the patients was 68 years (range 31-87 yrs). The monoclonal immunoglobulin was IgG in 77%, IgA in 11%, IgM in 9% and pure Bence-Jones proteinuria in 1%. Two patients had biclonal and one three-clonal gammopathy. The median value of the monoclonal immunoglobulin was 10.5 g/L (range 2-30 g/L). Thirty-one per cent of the patients with monoclonal immunoglobulin in serum had free light chains in urine too. The median value of serum monoclonal immunoglobulin in this group was greater (13 g/L) compared to the group without free light chains in urine (8.8 g/L). (Abstract truncated at 2000 characters.)
Summary		Izhodišča. Pod monoklonskim imunoglobulinom nedoločenega pomena (MINP) razumemo prisotnost monoklonskega imunoglobulina (MIg) v serumu ali urinu pri osebah, ki nimajo plazmocitoma, Waldenstromove makroglobulinemije, amiloidoze ali druge sorodne bolezni. Incidenca MINP je velika in v zadnjem času narašča. Pomen MINP je predvsem v možnosti preobrazbe v diseminirani plazmocitom ali sorodne bolezni. Metode. V prispevku smo obravnavali bolnike, pri katerih smo v obdobju desetih let na Kliničnem oddelku za hematologijo, KC Ljubljana, ugotovili MINP. Diagnostični kriteriji za MINP so bili koncentracija MIg v serumu <30 g/L, izločanje MIg v urinu <1g/dan, delež plazmatk v kostnem mozgu < 10% in odsotnost osteoliz ali drugih znakov plazmacitoma ali sorodnih bolezni. Rezultati. V obdobju 10 let smo ugotovili MINP pri 196 bolnikih. Število novoodkritih primerov je strmo narastlo v zadnjih letih obravnavanega obdobja. Odnos med moškim in ženskim spolom je bil 81/113, Mediana starosti bolnikov ob ugotovitvi MINP je bila 68 let (razpon 31-87 let). V 77% smo ugotovili monoklonski imunoglobulin razreda IgG, v 11% razreda IgA, v 9% razreda IgM in v 1% samo proste lahke verige v urinu. Dva bolnika sta imela v serumu dva, en bolnik pa tri monoklonske imunoglobuline. Mediana koncentracije MIg v serumu ob ugotovitvi je bila 10.5 g/L (razpon 2-30 g/L). V 31% smo poleg monoklonskega imunoglobulina v serumu ugotovili tudi prebitek lahkih verig v urinu. Pri teh bolnikih je bila koncentracija MIg v serumu večja (13 g/L) kot pri bolnikih brez prebitka lahkih verig (8,8g/L). (Izvleček prekinjen pri 2000 znakih.)
Descriptors		IMMUNOGLOBULINS PARAPROTEINEMIAS AGE FACTORS IGG IGA IGM AMYLOIDOSIS WALDENSTROM'S MACROGLOBULINEMIA