Giraldo P, Rubio-Félix D, Delgado P, Giralt M
Servicio Regional de Hematología y Hemoterapia, Hospital Miguel Servet, Zaragoza, España.
Sangre (Barc). 1994 Oct;39(5):351-5.
To evaluate the incidence of transitory monoclonal gammopathies (MG) defined as a narrow spike in serum electrophoresis disappearing after a variable period of time.
A follow up (1986-1992) in all the cases with "minimal" MG (< 10 g/L) to evaluate the transitory or permanent nature of the patients sera was performed along a 7-year period. Serum protein electrophoresis along with immunofixation electrophoresis were performed in order to identify and characterize the monoclonal components in all the cases.
Thirty four out of 592 monoclonal gammopathies (5.7% of the total and 8.6% of the non-myelomatous monoclonal components) fulfilled the criteria of transitory monoclonal gammopathies. There was predominance of adult patients (88.2%), females (64.7%) and subjects over 40 years of age (67.6%). The monoclonal component was small in all the cases (mean 4.5 g/L). After immunochemical characterization, IgG was found in 23 cases and IgM in 9; the light chain was Kappa in 25 and lambda in 7; two patients had 2 or 3 monoclonal components. In 31 of the 34 cases the associated pathology was infectious; this being neoplastic in 2 and hypersensitivity to drugs in the remaining patient. The infectious agents could be identified in 24 instances as mainly gram-negative bacteria.
评估短暂性单克隆丙种球蛋白病（MG）的发生率，其定义为血清电泳中出现的窄峰在一段时间后消失。
对所有“轻度”MG（<10 g/L）患者进行为期7年的随访（1986 - 1992年），以评估患者血清的短暂性或永久性特征。对所有病例进行血清蛋白电泳及免疫固定电泳，以鉴定和表征单克隆成分。
592例单克隆丙种球蛋白病中有34例（占总数的5.7%，非骨髓瘤单克隆成分的8.6%）符合短暂性单克隆丙种球蛋白病的标准。成年患者占优势（88.2%），女性（64.7%）以及40岁以上患者（67.6%）居多。所有病例中的单克隆成分均较小（平均4.5 g/L）。免疫化学表征后，发现23例为IgG，9例为IgM；轻链κ型25例，λ型7例；2例患者有2种或3种单克隆成分。34例中的31例相关病理为感染性；2例为肿瘤性，其余1例为药物超敏反应。24例可鉴定出感染病原体，主要为革兰氏阴性菌。
1）短暂性单克隆丙种球蛋白病的出现并非罕见发现。2）这种改变无任何预后意义。3）小单克隆成分的出现，尤其是在感染性疾病中，不应引发进一步深入研究。
