Research paperThe clinical spectrum of IgM monoclonal gammopathy: A single center retrospective study of 377 patients
Introduction
The presence of IgM monoclonal gammopathy can occur in a broad spectrum of diseases, including Waldenstrom macroglobulinemia (WM), various B cell non-Hodgkin’s lymphoma (NHL), multiple myeloma (MM), primary amyloidosis (AL), monoclonal gammopathy of undetermined significance (MGUS), and so on. The clinical manifestations of IgM monoclonal gammopathy related diseases vary widely from quiet lesions to aggressive, and potentially lethal, diseases [1], [2], [3]. This rare condition is often misdiagnosed due to rarity and heterogeneity. To date, there is little information regarding IgM monoclonal gammopathy related diseases. The prevalence, clinical manifestations, serum level of IgM, and type of light chain in each type of IgM related disease has never been reported comprehensively. In the current study, we retrospectively evaluated the patients with serum immunofixation electrophoresis (sIFE) confirmed IgM monoclonal gammopathy in a single consecutive cohort. We focused on the clinical features, serum levels of IgM, and the prevalence of IgM related diseases.
Section snippets
Patients
We included patients with sIFE confirmed IgM monoclonal gammopathy between January 2008 and December 2014 at Peking Union Medical College Hospital in this retrospective study. We collected clinical data, including age, sex, chief complaint, physical examination, sIFE, and routine laboratory analyses. Routine laboratory analyses included evaluation of complete blood count, levels of lactic dehydrogenase (LDH), levels of serum IgM. We also collected 18F Fluorodeoxyglucose positron emission
General characteristics
In total, there were 7107 patients with sIFE confirmed monoclonal gammopathy between January 2008 and December 2014 at Peking Union Medical College Hospital, with 377 patients having the IgM type (5.3%). That included 233 male patients (61.8%) and 144 female patients (38.2%). The median age of patients was 62 years (range, 19–105 years); 38 patients (10.1%) were younger than 40 years, whereas 291 patients (77.2%) were more than 50 years old, and 98 patients (26.0%) were aged 70 years or older.
Discussion
IgM monoclonal gammopathy is most frequently found in WM and IgM MGUS. The clinical spectrum, underlying disease, and prevalence of IgM monoclonal gammopathy have never been reported. This single-center study includes 7107 patients with sIFE confirmed monoclonal gammopathy, with IgM type accounting for 5.3%. That rate is similar to those reported in African American, native African, and Asian populations [11], [12], [13], while it is much lower than those reported in Caucasians [14]. In the
Conflict of interest
The authors report no conflicts of interest related to the content of this paper.
Acknowledgement
This study was not supported by any foundation.
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