Paraproteins are monoclonal immunoglobins that are present in the blood and urine. This protein is produced for the most part by plasma cells. Paraproteinaemia is a group of diseases that lead to an unbalanced or disproportionate production of cells that create immunoglobulins. Plasma cell disorder refers to a group of conditions that includes monoclonal gammopathy and symptomatic myeloma. About 3 per cent of those over 50 years old will suffer from this problem.
With regard to neoplastic conditions, there are three variants of the diseases. These variants are known as alpha, gamma and mu heavy chain disease. The alpha strain is the most widely seen, and tends to manifest mainly in those from the Mediterranean or Middle East.
Monoclonal gammopathy is caused by a low level of protein and bone marrow plasma. There might also be a lack of myeloma-related organ or renal, skeletal or bone marrow impairment. Patients might appear outwardly to be in good health, and are normally elderly. Generally, this condition does not require therapy, and only 1% of cases progress to myeloma.
Myeloma is an incurable condition. Life expectancy for those with the condition is about three to four years from the onset. Thalidomide and dexamethasone have a role to play in the treatment of this disease. Other diseases in the paraproteinaemia group are non-Hodgkin’s lymphoma, POEMS syndrome, autoimmune diseases, liver diseases, cutaneous diseases and infectious diseases such as tuberculosis and bacterial endocarditis.
Waldenstroms macroglobulinemia is condition that is similar in makeup to myeloma, lymphoma and chronic lymphatic leukaemia. Symptoms of this condition include weakness and fatigue. The condition is diagnosed through the use of serum electrophroesis and bone marrow aspiration.
Symptoms and related conditions
Symptoms and condition associated with this type of affliction include general malaise, fatigue, bone disease, impaired renal function, hypercalcaemia, bacterial infections, hyperviscosity and anemia. One might also experience nephrotic syndrome, cardiac failure and malabsorption, as well as carpal tunnel syndrome. This condition is often discovered unintentionally, and might also lead to fever and bone pain. Some forms of the condition, such as monoclonal gammopathy, can be completely asymptomatic in nature.Treatment
Treatment of this group of conditions will of course depend on the underlying cause or causes. Prognosis is generally quite poor with regard to survival and recovery rates. In those with monclonal gammopathy, there may be no manifestation of symptoms. There might also be no indication of any antibody response impairment.