Epidemiological and Biological Parameters of Monoclonal Plasma Cell Dyscrasias in Thirty One Patients Consulting a Moroccan Pasteur Institute

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.