الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
This study was done on 70 subjects: 20 ztppztcently heztlthy subjects as a control group and 50 patients with monoclonal gammopathy diagnosed clinically and laboratory by finding of M¬protein in their serum. All patients were classified according 10 clinical diagnosis into 2 main groups, plasma cell dyscrasia which included 35 patients, and lymphoprolihative disorders which included 15 patients.
All patients and controls were subjected to: Complete clinical examination and history taking, routine investigations which included, complete blood count, ESR, T. protein, serum albumin, alkal inc phosphatase, S.urea , creatinin and uric acid. Serum calcium, phosphorus, sodium and potassium, C-reactive protein, LDI-I.
Specific investigations which included, Serum protein electro¬phoresis, Bence Jones protein by heating method and by electrophoresis, plasma viscosity determination, cryoglobulin quantitation. Specific techniques such as serum protein immuno¬electrophoresis, serum protein immunofixation, ilTlmunoglobulin quantitation, and detection of light chain type in urine samples.
All patients subjected to 4 doses of chemotherapy, and then the same invesligcltions were done again.
The results shmved the frequency of Igs isotypes in group of plasma cell dyscrasias was IgG 51.4%, IgA 31.4%, IgM 11.4%, and
light chain disease 5.7%. In lymphoprolifrative disorders group, IgG was 13.3%, IgA 40% and IgM 46.7%.
The frequency of light chain in urine m the same group was 40% free kappa, 28.6% free lambda, and 31.4% negative for Bl protein. In group of Iymphoprolifrative disorders there were 20% free kappa, 33.3% free lambda and 46.7% negative BJ protein.
A 11 studied parameters showed significant changes after therapy such as elevation of hemoglobin levels, platelets count, serum albumin. Also, ESR, serum creatinin, serum calcium, eRP, LDB, and M-band were reduced in most cases. Monoclonal immunoglobulin quantity reduced with elevation of other normal immunoglobulins.
The results of the present study enabled use to suggest a strategy for investigation and follow up of patients with monoclonal gammopathy.
o Immunoelectrophoresis and Immunofixation can be used at first diagnosis to detect type of monoclona] gammopathy but not needed in follow up of the patients because they are semiquantitative tests.
o Serum protein electrophoresis on cellulose acetate or agaros gel
and den isometric scannmg of M-band, with aiding of immunoglobulins quanitation by turbidemetry can be used for follow up of patients.
:J Bence Jones protein must be detected at start of diagnosis to
solve a problem oflight chain disease, which cannot be diagnosed by routine electrophoresis, and to avoid occurrence of renal failure.