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Immune-mediated multisystem injury associated with monoclonal gammopathy of clinical significance: a case report - PubMed

3 hours ago
  • #Monoclonal Gammopathy
  • #Immune-Mediated Injury
  • #Case Report
  • MGCS involves pathogenic monoclonal immunoglobulins causing organ injury independent of tumor burden.
  • A 52-year-old man presented with cutaneous xanthomatosis, inflammatory myopathy, cryoglobulinemia, and possible cardiac involvement.
  • Symptoms included polymyalgia, leukopenia, and skin plaques, with immune abnormalities predating monoclonal protein detection.
  • Lab findings showed IgG-λ monoclonal gammopathy, type I cryoglobulinemia, complement consumption, and autoantibodies.
  • Bone marrow had only 1.4% λ-restricted clonal plasma cells, indicating low tumor burden.
  • Treatment with bortezomib-cyclophosphamide-dexamethasone led to significant clinical improvement.
  • Case highlights immune-mediated injury can precede detectable clonal expansion in MGCS.