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Relationship between rheumatoid arthritis and monoclonal gammopathy
Abstract:
The incidence of monoclonal gammopathy (MG) developing after the onset of rheumatoid arthritis (RA) was found to be 4.1%. Comparison of 12 patients with both diseases and a group of 215 control cases of RA showed the age of onset of RA was higher when MG was going to develop. In such cases, MG was heralded by lower or diminishing serum rheumatoid factor titers. Comparison of these 12 patients with 971 control cases of MG showed the same high frequency of patients with IgM-MG as that recently reported for a series in Western France. An unusually high but not significant incidence of patients with lambda light chains was observed. The reasons for this remain to be elucidated.
Insights
Rheumatoid arthritis (RA) patients have a 4.1% incidence of developing monoclonal gammopathy (MG). RA onset is later in these patients, often preceded by declining rheumatoid factor levels.
Area of Science:
- Rheumatology
- Hematology
- Immunology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Monoclonal gammopathy (MG) is characterized by the presence of monoclonal proteins in the blood.
- The relationship between RA and the subsequent development of MG requires further investigation.
Purpose of the Study:
- To determine the incidence of MG in RA patients.
- To identify clinical predictors of MG development in RA patients.
- To characterize the immunological profile of RA patients who develop MG.
Main Methods:
- Retrospective cohort study comparing RA patients who developed MG with RA-only controls.
- Analysis of demographic data, disease onset, and serological markers including rheumatoid factor (RF) titers.
- Comparison of MG characteristics in RA patients with a general MG cohort.
Main Results:
- The incidence of MG developing after RA onset was 4.1%.
- RA onset occurred at a higher age in patients who later developed MG.
- Diminishing serum rheumatoid factor titers preceded MG development in these patients.
- A high frequency of IgM-MG was observed, consistent with previous reports.
- An elevated, though not statistically significant, incidence of lambda light chains was noted.
Conclusions:
- Monoclonal gammopathy is a potential complication in rheumatoid arthritis patients.
- Later RA onset and decreasing RF titers may indicate an increased risk for MG.
- Further research is needed to understand the association with lambda light chains.