[Diagnosis and evaluation of monoclonal immunoglobulins in the aged with reference to plasmacytoma]

A study on the epidemiological situation of the appearance of monoclonal immunoglobulins (mIg) in the district of Leipzig is presented. 443 accidentally selected test persons from old people's and nursing homes of a dispensary consulting hour and a ward for diagnostics in internal medicine at the age of more than 50 years were examined. Agargel electrophoresis and BSR, the usual diagnostic follow-up methods for the proof of mIg, were used. Depending upon age 88 examined patients showed increasingly extragradients (EG), 21 of them could all be identified as mIg. Significant sex differences after the 74th year of age refer to an at this time more distinct disturbance of the B-cell regulation in males. One third of the test persons had transitory mIg, among the persisting ones after all two patients with multiple myeloma were found. While the BSR is not suitable as screening method, the agargel electrophoresis (sensitivity and specifity in each case 84%, positive predictive value 24%) in the present prevalency of 4.7% is recommended for the detection of this phenomenon. The clinical consequences require the formation of risk groups, their mass examination and the aimed control in immunologically and haematologically orientated centres.