Haematological Diseases with Oral Manifestations

Abstract

The paraproteinemias or monoclonal gammopathies all have in common the monoclonal production of immunoglobulins. Since the over-production is monoclonal from a single tumour stem cell, the immunoglobulins produced all have the same light chains, either kappa or lambda. The commonest paraproteinaemias produce IgG, or IgA or light chain (Bence-Jones) and come under the overall name of myelomatosis (multiple myeloma). The term macroglobulinaemia is used when IgM is produced. IgM paraprotein may be associated with malignant disease (non-Hodgkin’s lymphoma, Waldenström’s macroglobulinaemia and chronic lymphocytic leukaemia) or benign disorders (cold haemagglutinin disease, rheumatoid arthritis and some lymphoid disorders). In some elderly patients a benign monoclonal gammopathy may be found, and is not necessarily of any significance.