MONOCLONAL GAMMOPATHIES AND THE RELATED AUTOIMMUNE MANIFESTATIONS IN TAIWAN

A total of 50,000 patients were surveyed for the presence of monoclona l immunoglobulins during the past two decades. There were 411 cases of monoclonal gammopathies including 243 cases of plasma cell neoplasms and 168 cases of secondary plasma-cell dyscrasia. Among the 227 cases of multiple myeloma and Waldenstrom's macroglobulinemia, there were 49 .3% IgG class, 22.9% IgA class, 9.7% IgM class and 13.2% light chain t ype. In addition, there were 1.3% of nonexcretory myeloma including an IgM type. A relatively high frequency (4.8%) of IgD M-proteins was de tected but heavy chain disease was not encountered in the present seri es. Purified M-components from patients with possible autoimmune manif estations were subjected to immunofluorescence studies. Autoimmune act ivity of M-proteins was found in a patient of Waldenstrom's macroglobu linemia with peripheral neuropathy, and another patient of cryofibrino genemia with recurrent purpura and gangrene. In conclusion, a high fre quency of IgD myeloma is found in Chinese patients of this area. M-com ponents may have autoimmune activity resulting in unusual clinical man ifestations.