Monoclonal Gammopathy in Hereditary Spherocytosis: A Possible Pathogenetic Relation

  1. ANDREW I. SCHAFER, M.D.;
  2. J. BRUCE MILLER, M.D.;
  3. ERIC P. LESTER, M.D.;
  4. TIMOTHY K. BOWERS, M.D.; and
  5. HARRY S. JACOB, M.D.
  1. Chicago, Illinois, and Minneapolis, Minnesota

    Abstract

    Two cases of monoclonal gammopathy in patients with hereditary spherocytosis led us to consider the possbile pathogenetic relation between these two disorders. Twelve adult patients with hereditary spherocytosis had significant hypergammaglobulinemia in comparison to normal subjects. Retrospective analysis of previous illness in 140 patients with multiple myeloma showed a significant association between IgA myeloma and previous gallbladder disease. We propose that the chronic reticuloendothelial stimulation due to extravascular hemolysis, possibly potentiated by the inflammation associated with cholelithiasis and cholecystitis, may foster neoplastic transformation of immunocytes in patients with hereditary spherocytosis, ultimately leading to the development of monoclonal gammopathy.

    Article and Author Information

    • ▸From the Department of Medicine, The University of Chicago Pritzker School of Medicine, and The Franklin McLean Memorial Research Institute, Chicago, Illinois; and the Department of Medicine, The University of Minnesota School of Medicine, Minneapolis, Minnesota.

    • ▸Requests for reprints should be addressed to J. Bruce Miller, M.D.; Department of Medicine, Box 302, The University of Chicago, 950 East 59th St.; Chicago, IL 60637.

      • Received April 27, 1977.
      • Accepted October 4, 1977.
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    1. Ann Intern Med January 1, 1978 vol. 88 no. 1 45-46
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