1. Evidence for immunoglobulin-mediated vasculitis caused by monoclonal gammopathy in monoclonal gammopathy of unclear significance prompting oncologic treatment
- Author
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Dieter Metze, Carolin Mitschang, Matthias Neufeld, Jan Ehrchen, Christian Drerup, and Cord Sunderkötter
- Subjects
IgG/IgM vasculitis ,medicine.medical_specialty ,Case Report ,Dermatology ,Disease ,LCV, leukocytoclastic vasculitis ,MGUS, monoclonal gammopathy of unclear significance ,immune complex vasculitis ,IgA vasculitis ,PAS, periodic acid–Schiff ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,immune system diseases ,hemic and lymphatic diseases ,Gammopathy ,medicine ,cardiovascular diseases ,Anti-neutrophil cytoplasmic antibody ,biology ,leukocytoclastic vasculitis ,business.industry ,PNP, polyneuropathy ,medicine.disease ,occlusive vasculopathy ,Monoclonal gammopathy ,030220 oncology & carcinogenesis ,gammopathy ,biology.protein ,monoclonal gammopathy of unclear significance ,Antibody ,medicine.symptom ,business ,Vasculitis ,ANCA, Antineutrophil cytoplasmic antibody ,Polyneuropathy - Abstract
Although it is unquestionable that monoclonal gammopathy causes occlusive nonvasculitic vasculopathy,1 it is not clear yet, if it can cause immunoglobulin-mediated leukocytoclastic vasculitis (LcV) and how vigorously both conditions should be treated in monoclonal gammopathy of unclear significance (MGUS). In the recent nomenclature of cutaneous vasculitides (addendum to the CHCC2012),2 vasculitis in MGUS is mentioned as a possible, so-far unproven entity. Previous case reports did not sufficiently or explicitly distinguish it from occlusive vasculopathy. Adding to this dilemma is a lack of consensus with oncologists if or when chemotherapies are justified in MGUS with a paraprotein-associated disease. We provide evidence by means of 2 cases of MGUS that monoclonal gammopathy can cause primary immunoglobulin-mediated LcV and that its oncologic treatment abolishes it.
- Published
- 2019