[Monoclonal gammopathies]

Area of Science:

• Hematology
• Neurology
• Nephrology

Context:

• Monoclonal gammopathies can manifest independently of associated hemopathies.
• Cryoglobulins (Types I and II) are linked to cutaneous lesions, peripheral neuropathy, and membranoproliferative glomerulopathy.
• Peripheral neuropathies in monoclonal gammopathy are often chronic, progressive, and associated with antibodies against myelin-associated glycoprotein.

Purpose:

• To review the diverse clinical manifestations of monoclonal gammopathies.
• To highlight the role of cryoglobulins and immunoglobulin light chain deposits in organ damage.
• To discuss POEMS syndrome and other rare manifestations.

Summary:

• Monoclonal gammopathies can lead to significant clinical issues including neuropathy, glomerulopathy, and skin conditions.
• POEMS syndrome (polyneuropathy, organomegaly, endocrine disorder, monoclonal component, skin disease) is a key manifestation.
• Other potential complications include angioneurotic edema, acquired von Willebrand disease, and systemic capillary leak syndrome.

Impact:

• Understanding these associations is crucial for accurate diagnosis and management.
• Effective treatment of the underlying monoclonal gammopathy can lead to control of associated symptoms.
• This review emphasizes the systemic impact of monoclonal gammopathies beyond hematological parameters.