Epidemiological and Biological Parameters of Monoclonal Plasma Cell Dyscrasias in Thirty One Patients Consulting a Moroccan Pasteur Institute
Ilham Zahir *
Department of Biology, Faculty of Sciences and Technical, University Sidi Mohamed Ben Abdellah, BP 2202, Road of Immouzer, Fez, Morocco
Abderahman Bellik
Department of Biology, Laboratory of Immunochemistry, Pasteur institute, Casablanca, Morocco
*Author to whom correspondence should be addressed.
Abstract
Aims: To describe epidemiological and biological features of patients with monoclonal plasma cell dyscrasias. The patients were seen at the Moroccan Pasteur Institute in Casablanca during a period of two years and four months.
Place and Duration of Study: Laboratory of immunochemistry, Pasteur institute, Casablanca, Morocco. From April 2006 to July 2006.
Methodology: Thirty one case notes of patients who had a serum or urine monoclonal gamma or beta globulin spike were assessed.
Results: The mean age of the patients was 54.7±10.7 years (range, 26–72 years) and there were more females with a sex ratio 0.82. 66.7% of the patients had a monoclonal gamma globulin peak revealed by electrophoresis. According the results of performed agar gel immuno-electrophoresis, 48% of them had monoclonal immunoglobulin G (IgG) antibodies, followed by class IgA with 29% of cases. Moreover, 55% of the patients were Kappa-chain positive, while 45% were Lambda-chain positive. Assessment of prognostic factors of some patients demonstrated an increased erythrocyte serum rate (66.7% of cases), anemia (50% of cases), a raised of calcium serum levels (37.5% of cases) and β2-microglobulin serum levels were higher than 3.5 mg/l (33.3% of cases). In addition, the mean concentration of proteins was 91 g/l (58.6% of cases), low levels of albumin below 36 g/l were observed (63% of cases) and the monoclonal component levels were above 30 g/l (55.6% of cases).
Conclusion: Some of our records were different from those of other series: our patients were younger with a slight predominance of female individuals. Others were consistent mainly with the more frequently observed monoclonal gamma-globulin peak, and also with the assessed levels of IgG, which is known as the most common isotype in plasma cell disorders. On the other hand, a rise of prognostic factors levels was also noted except for C-reactive protein. Nevertheless, our study pointed out that the majority of patients didn’t have a rigorous monitoring of their disorders by carrying out hematological and serological examinations.
Keywords: Plasma cell dyscrasias, electrophoresis, immuno-electrophoresis, prognostic factors