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Transient monoclonal gammopathy induced by Candida fungemia
Joanna L Conant1, Ian Rabinowitz2, Qian-Yun Zhang1
1University of New Mexico, Department of Hematopathology, Albuquerque, NM 87102.
Abstract:
A 41-year-old woman was admitted for Candida fungemia. On hospital day 4, a routine complete blood count and peripheral smear showed circulating plasma cells. Initial workup showed an M-component on serum protein electrophoresis with 6% λ-predominate plasma cells by flow cytometry. The patient was treated with intravenous antifungal therapy. Her 6-month follow-up laboratory evaluation revealed resolution of the M-component and only rare polyclonal plasma cells in peripheral blood by flow cytometry. This case illustrates that transient monoclonal gammopathy can be induced by fungal infection. It is important to exclude a plasma cell neoplasm or a B-cell lymphoma and to follow the patient until resolution of abnormal findings.
Insights
Fungal infections, like Candida fungemia, can transiently cause monoclonal gammopathy, a condition with abnormal proteins. This highlights the need to rule out plasma cell cancers and monitor patients until lab results normalize.
Area of Science:
- Hematology
- Infectious Diseases
- Immunology
Background:
- Candida fungemia is a serious bloodstream infection.
- Monoclonal gammopathy is characterized by the overproduction of a single immunoglobulin type.
Observation:
- A patient with Candida fungemia developed circulating plasma cells and an M-component.
- Flow cytometry revealed λ-predominate plasma cells, indicating monoclonal gammopathy.
Findings:
- Treatment with antifungal therapy led to the resolution of the M-component.
- Peripheral blood analysis showed only rare polyclonal plasma cells post-treatment.
Implications:
- Transient monoclonal gammopathy can be triggered by fungal infections.
- It is crucial to differentiate this from plasma cell neoplasms or B-cell lymphomas.
- Long-term patient follow-up is essential to confirm the resolution of abnormal findings.
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