Monoclonal Gammopathy of Unclear Significance in a Child with Wiskott-Aldrich Syndrome: a Rare Occurrence
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To the Editor,
The presence of anomalously high monoclonal immunoglobulins or paraproteins in serum is seldom encountered in patients with abnormal proliferation of B cells. In these conditions, elevated levels of light chains, heavy chains, or whole immunoglobulins (hypergammaglobulinemia) may be detected in serum. Wiskott Aldrich Syndrome (WAS), a rare combined primary immunodeficiency disorder, is characterized by eczema, thrombocytopenia, and susceptibility to infections. Immunoglobulin levels in patients with WAS conventionally reveal normal to high IgG and IgA, normal to low IgM and high IgE levels, though these can be extremely variable. Monoclonal gammopathy has been rarely described in patients with WAS. Chronic antigenic stimulation due to frequent infections coupled with ineffective specific antibody production results in a coincidental increase in amount of non-specific antibodies and paraproteins. We report a child with WAS who was found to have monoclonal gammopathy of...
(Rashmi Rikhi: RR; Sagar Bhattad: SB; Ankur Kumar Jindal: AK; Biman Saikia BS; Ravinder Garg: RG; Amit Rawat: AR; Deepti Suri: DS; Surjit Singh: SS)
DS, AR, SB, AK, and RR conceptualized; AK, SB, and RR did data collection; SS, DS, AR, SB, AJ, BS, and RR analyzed; RG performed electrophoresis for paraprotein determination; DS, RR, and AJ drafted the manuscript; and DS and AR critically analyzed the manuscript. SS, DS, AR, and RR are responsible for the overall content as guarantors.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Department Review Board (DRB), Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research Chandigarh, has approved the study.
Informed consent was obtained from the parents of the child.
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