Monoclonal gammopathy of undetermined significance with systemic lupus erythematosus: a case and literature review

VernacularTitle:系统性红斑狼疮合并意义未明单克隆免疫球蛋白血症一例并文献复习
Author: Xu LIU ; Fang HOU ; Xue FAN ; Shi CHEN ; Zhanguo LI
Publication Type:Journal Article
Keywords: Lupus erythematosus,systemic; Immunoglobulin M; Multiple myeloma; Monoclonal gammopathy of undetermined significance
From: Chinese Journal of Rheumatology 2013;(7):463-467
CountryChina
Language:Chinese
Abstract: Objective To better understand the clinical features and the diagnosis of monoclonal gammopathy of undetermined significance (MGUS) associated with systemic lupus erythematosus (SLE).Methods A case of MGUS with SLE were described including clinical manifestations and pathologic data.Literatures were also reviewed.Results The patient was admitted because of proteinuria.Laboratory findings showed monoclonal gammopathy.However,both bone marrow exam and iconography showed no signs of multiple myeloma.Lupus nephritis Ⅳ + Ⅴ was proved by kidney biopsy.Prednisone and tacrolimus were used with significant clinical improvement.Conclusion MGUS associated with SLE is not rare.MGUS criteria based on 2003 international MM working group should be used to differentiate MGUS from MM.Monoclonal protein level,plasma cell in bone marrow and free light chain are risk factors for MM progression.Treatment is based on lupus disease activity and organ damage severity.