Chuang C Y, Jen Y S, Sheikh M H, Huang T S
Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi. 1981 Sep;14(3):196-204.
The demonstration of monoclonal, homogeneous immunoglobulin or its subunit is the hallmark of plasma-cell dyscrasia. Plasma-cell dyscrasia can be classified into two main groups: "primary" and "secondary". The increasing use of protein electrophoresis and immunoelectrophoresis has contributed to the increased frequency of secondary monoclonal gammopathy and to the better recognition of its clinical significance. Secondary monoclonal gammopathy usually stems from the reactive unbalanced proliferation of B cells resulting from chronic inflammatory diseases or from other malignancies. Only in some cases its cause is difficult to assert. A case of secondary plasma-cell dyscrasia of undetermined cause is presented. The patient had IgG kappa monoclonal gammopathy of 3580 mg/dl, and multiple osteolytic bone lesions. However the histopathological picture showed a chronic inflammatory process, and the diagnosis of multiple myeloma could not be established. The diagnostic problems in this case are discussed, with the recommendation that more strict and accurate immunochemical terms concerning monoclonal gammopathy be used.
单克隆、均一性免疫球蛋白或其亚基的证实是浆细胞异常增殖症的标志。浆细胞异常增殖症可分为两大类：“原发性”和“继发性”。蛋白质电泳和免疫电泳的日益广泛应用，使得继发性单克隆丙种球蛋白病的检出率增加，并使其临床意义得到了更好的认识。继发性单克隆丙种球蛋白病通常源于慢性炎症性疾病或其他恶性肿瘤导致的B细胞反应性不均衡增殖。只有在某些情况下，其病因难以确定。本文报告一例病因不明的继发性浆细胞异常增殖症病例。该患者IgG κ单克隆丙种球蛋白水平为3580 mg/dl，并伴有多处溶骨性骨病变。然而，组织病理学表现为慢性炎症过程，无法确诊为多发性骨髓瘤。本文讨论了该病例的诊断问题，并建议使用更严格、准确的关于单克隆丙种球蛋白病的免疫化学术语。
