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Annals of Hematology

, Volume 98, Issue 10, pp 2431–2432 | Cite as

How to resolve a clinical and molecular puzzle: concomitant monoclonal gammopathy of undetermined significance (MGUS) with neutrophilia and clonal hematopoiesis of indeterminate potential (CHIP)

  • Simon Haefliger
  • Darius Juskevicius
  • Sylvia Höller
  • Ulrich Buser
  • Stefan Dirnhofer
  • Alexandar TzankovEmail author
Letter to the Editor

Dear Editor,

The association between plasma cell (PC) neoplasms (PCN) and neutrophilia is a rare but well-known phenomenon [1, 2, 3]. CHIP designates asymptomatic presence of clones in the peripheral blood and/or the bone marrow carrying somatic mutations of genes, typically mutated in myeloid neoplasms, with a not exactly predictable risk of progression towards cancer, bearing analogies to MGUS and monoclonal B-lymphocytosis [4, 5]. We report on a patient with concomitant MGUS, neutrophilia, and CHIP, rising questions of the nature of neutrophilia in PCN as well as caveats of overinterpretation due to the simultaneous co-existence of MGUS and CHIP.

A 60-year-old Caucasian male presented with fatigue and splenomegaly in 2008. Blood counts showed leukocytosis with mature neutrophilia [leukocytes of 32 g/L (reference, 4-12 G/L) with 90% neutrophils (28.8 G/L)]. Immunofixation electrophoresis revealed IgG κmonoclonal gammopathy (13.1 g/L (reference, 0.7–1.6 g/L)) without CRAB criteria....

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of informed consent

Written informed consent was obtained from the patient.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of PathologyUniversity of Basel, University Hospital BaselBaselSwitzerland

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