意义不明的多发性骨髓瘤和单克隆γ病患者的自身免疫表现

Alexei Shimanovsky , Argote J. Alvarez , Shruti Murali , Constantin A. Dasanu
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引用次数: 54

摘要

背景:在医学文献中,多发性骨髓瘤(MM)及其前体,未确定意义的单克隆γ病(MGUS)与几种自身免疫性疾病有关。然而,这些关联的意义还没有得到很好的理解。方法在本文中,我们对MM和MGUS患者的自身免疫性疾病进行了全面的文献回顾。通过检索PubMed/Medline和EMBASE数据库,查找从成立到2016年5月1日发表的文章,确定了大多数相关论文。关于MM和MGUS患者自身免疫状况的科学文献包括几个病例系列和大量病例报告。我们的分析表明,在MM和未确定意义单克隆γ病(MGUS)患者中,自身免疫性疾病的患病率增加,包括各种自身免疫性血液学和风湿病等疾病。相反,患有各种自身免疫性疾病的人往往比一般人群有更高的MGUS和MM患病率。结论需要进一步研究MGUS/MM与自身免疫性疾病之间的联系。自身免疫环境下的炎症可能是MGUS和MM的触发因素。此外,自身免疫性疾病和MM/MGUS的共同遗传易感性也可能存在。自身免疫性血液病和风湿病可能是MM患者的重要临床问题。因此,这些问题的目录是重要的,以便医生能够考虑,识别和及时解决它们。
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Autoimmune manifestations in patients with multiple myeloma and monoclonal gammopathy of undetermined significance

Background

Multiple myeloma (MM) and its precursor, monoclonal gammopathy of undetermined significance (MGUS), have been linked with several autoimmune conditions in the medical literature. Yet, significance of these associations is not well understood.

Methods

Herein, we provide a comprehensive literature review on autoimmune disorders identified in patients with MM and MGUS. Most relevant papers were identified via searching the PubMed/Medline and EMBASE databases for articles published from inception until May 1, 2016.

Findings

Scientific literature on autoimmune conditions in patients with MM and MGUS consists of several case series and a multitude of case reports. Our analysis suggests an increased prevalence of autoimmune conditions in patients with MM and monoclonal gammopathy of undetermined significance (MGUS), including various autoimmune hematologic and rheumatologic conditions among other entities. Conversely, persons with various autoimmune conditions tend to have a higher prevalence of MGUS and MM than the general population.

Conclusions

Future research is required to explore further the link between MGUS/MM and autoimmune disorders. Inflammation in the setting of autoimmunity may serve as a trigger for MGUS and MM. In addition, a common genetic susceptibility for developing both an autoimmune disease and MM/MGUS might also exist. Autoimmune hematologic and rheumatologic diseases may pose important clinical problems for the MM patients. Therefore, a catalogue of these problems is important so that physicians are able to consider, identify and address them promptly.

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