Broggini M, Cavallo A, Baratelli E, Volonté S, Crespi E, Cappelli A, Chelazzi G
Divisione di Medicina generale, Ospedale F. del Ponte, Varese.
Recenti Prog Med. 1990 May;81(5):306-9.
Among 358 patients with rheumatic diseases, the incidence of monoclonal gammopathy of undetermined significance (MGUS) as detected by immunofixation was 4.4% (11 of 248 patients) in rheumatoid arthritis (RA), 3% (1 of 32 patients) in systemic lupus erythematosus (SLE), 6% (3 of 49 patients) in Sjögren's syndrome (SS) and 3% (1 of 29 patients) in progressive systemic sclerosis (PSS). Solid tumor was present in 4 (36%) of the 11 RA-MGUS patients. In these cases the monoclonal component could be related to a paraneoplastic syndrome rather than to rheumatic diseases. The association of rheumatic diseases, MGUS, solid tumor and immunological disorders are discussed.
在358例风湿性疾病患者中,免疫固定法检测到的意义未明的单克隆丙种球蛋白病(MGUS)发病率在类风湿关节炎(RA)患者中为4.4%(248例患者中的11例),系统性红斑狼疮(SLE)患者中为3%(32例患者中的1例),干燥综合征(SS)患者中为6%(49例患者中的3例),进行性系统性硬化症(PSS)患者中为3%(29例患者中的1例)。11例RA-MGUS患者中有4例(36%)存在实体瘤。在这些病例中,单克隆成分可能与副肿瘤综合征有关,而非与风湿性疾病有关。本文讨论了风湿性疾病、MGUS、实体瘤和免疫紊乱之间的关联。