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Are monoclonal gammopathies in rheumatoid arthritis predictive for lymphoproliferative disorders?
MedLine Citation:
PMID:  17041377     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
There is limited evidence for the association of specific malignancies with rheumatoid arthritis (RA). Monoclonal gammopathies can occur in RA. Their predictive value for the development of a lymphoproliferative disorder remains unclear and disputed. We reviewed charts of 214 RA patients all of whom had at least one serum protein electrophoresis. We performed a retrospective study of 12 patients with RA and an M spike. We further characterized the M spike by serum immunofixation and bone marrow studies. The median age at which the M spike was identified was 69 years. IgG was the predominant gammopathy in 50% of patients, with no difference in the amount of kappa (kappa) and lambda (lambda) chains. One patient was diagnosed with multiple myeloma, one with an undefined primary lymphoproliferative disorder, one with T-cell leukemia, five with myelodysplastic syndrome, and four with monoclonal gammopathy of undetermined significance at most recent evaluation. Of our patients, 42% had a myelodysplastic syndrome, which has not been previously reported, and, in contrast to previous reports, no lymphomas were identified. The follow-up evaluation of patients with myelodysplastic syndrome and monoclonal gammopathy of undetermined significance is important because they may progress to an overt neoplasia.
Authors:
Luis A Toro-Jiménez; William Cáceres; Edwin Mejías
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases     Volume:  8     ISSN:  1076-1608     ISO Abbreviation:  J Clin Rheumatol     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2006-10-16     Completed Date:  2007-07-10     Revised Date:  2008-04-10    
Medline Journal Info:
Nlm Unique ID:  9518034     Medline TA:  J Clin Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  243-6     Citation Subset:  -    
Affiliation:
San Juan Veterans Affairs Medical Center, San Juan, Puerto Rico 00921, USA.
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