Monoklonale Gammopathie unklarer Signifikanz bei rheumatologischen Erkrankungen

Zusammenfassung

In der rheumatologischen Praxis wird eine monoklonale Gammopathie (MGUS) häufig als Zufallsbefund entdeckt. Meist handelt es sich um einen Laborbefund ohne Krankheitswert, diese Fälle werden als monoklonale Gammopathien unklarer Signifikanz (MGUS) bezeichnet. Für mehrere rheumatisch-entzündliche Systemerkrankungen ist ein erhöhtes Risiko für MGUS bekannt. Aus einer MGUS kann sich ein multiples Myelom, eine primär systemische Amyloidose oder eine andere lymphatische Neoplasie entwickeln. Die relevanten Krankheitsdefinitionen werden genannt und es werden Algorithmen aufgezeigt, um eine monoklonale Gammopathie weiter abzuklären und abhängig vom Progressionsrisiko Verlaufskontrollen vorzunehmen. Die Erkenntnisse darüber, ob rheumatologische Therapien Einfluss auf das Progressionsrisiko haben, sind bislang begrenzt.

Abstract

In rheumatology practice, monoclonal gammopathy of undetermined significance is a common incidental finding. Most often, gammopathies are benign in nature and lack associated symptoms. For this phenomenon, the term “monoclonal gammopathy of undetermined significance (MGUS)” has been coined. Several rheumatic inflammatory diseases are known to be associated with an elevated risk of MGUS. MGUSs may evolve into multiple myeloma, systemic light-chain amyloidosis or other lymphatic malignancies. This article provides relevant definitions of disease entities and highlights algorithms for further diagnostic work-up and follow-up for monoclonal gammopathy.

Schlüsselwörter

Monoklonale Gammopathie unklarer Signifikanz - rheumatoide Arthritis - Sjögren-Syndrom - Basistherapie

Key words

monoclonal gammopathy of undetermined significance - rheumatoid, arthritis - Sjögren’s syndrome - disease-modifying antirheumatic drugs

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