Abildgaard Niels
Ugeskr Laeger. 2021 Oct 18;183(42).
Monoclonal gammopathies range from benign conditions to severe malignancies. A summary is given in this review. Overall, the prevalence is high; monoclonal gammopathies (MGUS) occur in > 3% of persons above 50 years of age. Approximately 400 new cases of multiple myeloma and 80 new cases of amyloid light-chain (AL) amyloidosis are diagnosed yearly in Denmark. MGUS is most often asymptomatic, but M-protein associated syndromes exist and should be considered when finding M-protein. Serum free light kappa and lambda chain analysis, CT, PET/CT and whole-body MRI have revolutionised diagnostics and monitoring of monoclonal gammopathies. New treatment modalities have improved outcome in multiple myeloma and AL amyloidosis.
单克隆丙种球蛋白病涵盖从良性疾病到严重恶性肿瘤的范围。本综述对此进行了总结。总体而言,患病率较高;意义未明的单克隆丙种球蛋白病(MGUS)在50岁以上人群中的发生率超过3%。在丹麦,每年约有400例新诊断的多发性骨髓瘤病例和80例新诊断的轻链(AL)淀粉样变性病例。MGUS通常无症状,但存在与M蛋白相关的综合征,在发现M蛋白时应予以考虑。血清游离轻链κ和λ链分析、CT、PET/CT和全身MRI彻底改变了单克隆丙种球蛋白病的诊断和监测。新的治疗方式改善了多发性骨髓瘤和AL淀粉样变性的治疗效果。