Monoclonal gammopathy in association with allergic disorders of the skin and respiratory tract

Bernard A. Silverman, Min Ku, Prianka Kapur, Arlene T. Schneider

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Monoclonal gammopathy is a condition characterized by the abnormal proliferation of a single clone of plasma cells, which produces a homogeneous monoclonal protein. It has been reported to occur in association with urticaria in the context of Schnitzler's syndrome and also has been observed to occur in angioedema with acquired C1 esterase inhibitor deficiency. We report 11 cases of monoclonal gammopathy presenting to practicing allergists (>2.5% of those screened) primarily in association with dermatologic disorders, i.e., urticaria, angioedema, and nonspecific dermatitis, but also with allergic respiratory disorders, i.e., allergic rhinitis, chronic sinusitis, and asthma. Most of the patients with dermatologic manifestations had respiratory disorders as well, three with chronic sinusitis. To our knowledge, these are the only such cases reported in patients with urticaria or angioedema in the absence of Schnitzler's syndrome or C1 inhibitor deficiency or in association with chronic sinusitis, allergic rhinitis, or asthma. Monoclonal gammopathy, angioedema, urticaria, allergic respiratory disorders, and sinusitis could be linked through antigenic stimulation as a trigger, either infectious, as in chronic sinusitis; self-antigens, as in autoimmunity; or the monoclonal gammopathy itself, causing idiotype-anti-idiotype immune complexes and inflammatory disease. The allergist, dermatologist, otolaryngologist, and primary care physician should all maintain a high index of suspicion for the occurrence of monoclonal gammopathy in the "allergic" population. Serum protein electrophoresis and/or serum immunofixation are useful screening tools. When monoclonal gammopathy is found, the presence of light chains in the urine should be assessed and the patient should be referred for prompt hematology-oncology evaluation with periodic monitoring for the development of plasma cell dyscrasias. Additional prospective study is necessary to determine the true prevalence of monoclonal gammopathy in the population presenting to the practicing allergist.

Original languageEnglish (US)
Pages (from-to)130-139
Number of pages10
JournalAllergy and Asthma Proceedings
Volume27
Issue number2
StatePublished - Mar 1 2006
Externally publishedYes

Fingerprint

Paraproteinemias
Respiratory System
Sinusitis
Skin
Urticaria
Angioedema
Schnitzler Syndrome
Hereditary Angioedemas
Asthma
Immune Complex Diseases
Autoantigens
Primary Care Physicians
Dermatitis
Hematology
Plasma Cells
Autoimmunity
Population
Electrophoresis
Blood Proteins
Clone Cells

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Monoclonal gammopathy in association with allergic disorders of the skin and respiratory tract. / Silverman, Bernard A.; Ku, Min; Kapur, Prianka; Schneider, Arlene T.

In: Allergy and Asthma Proceedings, Vol. 27, No. 2, 01.03.2006, p. 130-139.

Research output: Contribution to journalArticle

@article{fd4b8ca48c754344b60ec7bdece66d7e,
title = "Monoclonal gammopathy in association with allergic disorders of the skin and respiratory tract",
abstract = "Monoclonal gammopathy is a condition characterized by the abnormal proliferation of a single clone of plasma cells, which produces a homogeneous monoclonal protein. It has been reported to occur in association with urticaria in the context of Schnitzler's syndrome and also has been observed to occur in angioedema with acquired C1 esterase inhibitor deficiency. We report 11 cases of monoclonal gammopathy presenting to practicing allergists (>2.5{\%} of those screened) primarily in association with dermatologic disorders, i.e., urticaria, angioedema, and nonspecific dermatitis, but also with allergic respiratory disorders, i.e., allergic rhinitis, chronic sinusitis, and asthma. Most of the patients with dermatologic manifestations had respiratory disorders as well, three with chronic sinusitis. To our knowledge, these are the only such cases reported in patients with urticaria or angioedema in the absence of Schnitzler's syndrome or C1 inhibitor deficiency or in association with chronic sinusitis, allergic rhinitis, or asthma. Monoclonal gammopathy, angioedema, urticaria, allergic respiratory disorders, and sinusitis could be linked through antigenic stimulation as a trigger, either infectious, as in chronic sinusitis; self-antigens, as in autoimmunity; or the monoclonal gammopathy itself, causing idiotype-anti-idiotype immune complexes and inflammatory disease. The allergist, dermatologist, otolaryngologist, and primary care physician should all maintain a high index of suspicion for the occurrence of monoclonal gammopathy in the {"}allergic{"} population. Serum protein electrophoresis and/or serum immunofixation are useful screening tools. When monoclonal gammopathy is found, the presence of light chains in the urine should be assessed and the patient should be referred for prompt hematology-oncology evaluation with periodic monitoring for the development of plasma cell dyscrasias. Additional prospective study is necessary to determine the true prevalence of monoclonal gammopathy in the population presenting to the practicing allergist.",
author = "Silverman, {Bernard A.} and Min Ku and Prianka Kapur and Schneider, {Arlene T.}",
year = "2006",
month = "3",
day = "1",
language = "English (US)",
volume = "27",
pages = "130--139",
journal = "Allergy and Asthma Proceedings",
issn = "1088-5412",
publisher = "OceanSide Publications Inc.",
number = "2",

}

TY - JOUR

T1 - Monoclonal gammopathy in association with allergic disorders of the skin and respiratory tract

AU - Silverman, Bernard A.

AU - Ku, Min

AU - Kapur, Prianka

AU - Schneider, Arlene T.

PY - 2006/3/1

Y1 - 2006/3/1

N2 - Monoclonal gammopathy is a condition characterized by the abnormal proliferation of a single clone of plasma cells, which produces a homogeneous monoclonal protein. It has been reported to occur in association with urticaria in the context of Schnitzler's syndrome and also has been observed to occur in angioedema with acquired C1 esterase inhibitor deficiency. We report 11 cases of monoclonal gammopathy presenting to practicing allergists (>2.5% of those screened) primarily in association with dermatologic disorders, i.e., urticaria, angioedema, and nonspecific dermatitis, but also with allergic respiratory disorders, i.e., allergic rhinitis, chronic sinusitis, and asthma. Most of the patients with dermatologic manifestations had respiratory disorders as well, three with chronic sinusitis. To our knowledge, these are the only such cases reported in patients with urticaria or angioedema in the absence of Schnitzler's syndrome or C1 inhibitor deficiency or in association with chronic sinusitis, allergic rhinitis, or asthma. Monoclonal gammopathy, angioedema, urticaria, allergic respiratory disorders, and sinusitis could be linked through antigenic stimulation as a trigger, either infectious, as in chronic sinusitis; self-antigens, as in autoimmunity; or the monoclonal gammopathy itself, causing idiotype-anti-idiotype immune complexes and inflammatory disease. The allergist, dermatologist, otolaryngologist, and primary care physician should all maintain a high index of suspicion for the occurrence of monoclonal gammopathy in the "allergic" population. Serum protein electrophoresis and/or serum immunofixation are useful screening tools. When monoclonal gammopathy is found, the presence of light chains in the urine should be assessed and the patient should be referred for prompt hematology-oncology evaluation with periodic monitoring for the development of plasma cell dyscrasias. Additional prospective study is necessary to determine the true prevalence of monoclonal gammopathy in the population presenting to the practicing allergist.

AB - Monoclonal gammopathy is a condition characterized by the abnormal proliferation of a single clone of plasma cells, which produces a homogeneous monoclonal protein. It has been reported to occur in association with urticaria in the context of Schnitzler's syndrome and also has been observed to occur in angioedema with acquired C1 esterase inhibitor deficiency. We report 11 cases of monoclonal gammopathy presenting to practicing allergists (>2.5% of those screened) primarily in association with dermatologic disorders, i.e., urticaria, angioedema, and nonspecific dermatitis, but also with allergic respiratory disorders, i.e., allergic rhinitis, chronic sinusitis, and asthma. Most of the patients with dermatologic manifestations had respiratory disorders as well, three with chronic sinusitis. To our knowledge, these are the only such cases reported in patients with urticaria or angioedema in the absence of Schnitzler's syndrome or C1 inhibitor deficiency or in association with chronic sinusitis, allergic rhinitis, or asthma. Monoclonal gammopathy, angioedema, urticaria, allergic respiratory disorders, and sinusitis could be linked through antigenic stimulation as a trigger, either infectious, as in chronic sinusitis; self-antigens, as in autoimmunity; or the monoclonal gammopathy itself, causing idiotype-anti-idiotype immune complexes and inflammatory disease. The allergist, dermatologist, otolaryngologist, and primary care physician should all maintain a high index of suspicion for the occurrence of monoclonal gammopathy in the "allergic" population. Serum protein electrophoresis and/or serum immunofixation are useful screening tools. When monoclonal gammopathy is found, the presence of light chains in the urine should be assessed and the patient should be referred for prompt hematology-oncology evaluation with periodic monitoring for the development of plasma cell dyscrasias. Additional prospective study is necessary to determine the true prevalence of monoclonal gammopathy in the population presenting to the practicing allergist.

UR - http://www.scopus.com/inward/record.url?scp=33646488846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646488846&partnerID=8YFLogxK

M3 - Article

C2 - 16724632

AN - SCOPUS:33646488846

VL - 27

SP - 130

EP - 139

JO - Allergy and Asthma Proceedings

JF - Allergy and Asthma Proceedings

SN - 1088-5412

IS - 2

ER -