Monoclonal gammopathy in chronic active hepatitis

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Abstract
Immunoelectrophoresis was performed in 31 of 272 patients with chronic active hepatitis (CAH) because of an M-spike component (7 patients, 2.6%) or hypergammaglobulinemia (24 patients) revealing a monoclonal gammopathy (MG) in 11 patients. In addition, 50 randomly selected patients with CAH and no evidence for an M-spike component were tested by immunoelectrophoresis. In 13 patients (26%), an MG was found. The mean age of the 24 patients with MG was 57.4 yr (range: 23-76). HBsAg [hepatitis B surface antigen] was present in 9 patients (37.5%); no HBV[hepatitis B virus]-marker was detected in 10 patients (41.7%). The Ig class of MG was IgG in 10 patients (41.7%), IgA in 1 patient (4.2%) and IgM in 11 patients (45.8%). In 2 patients, Bence Jones protein was found in either serum or urine. In only 1 patient was the MG associated with multiple myeloma; none of the other 23 patients developed a malignant lymphoproliferative disease within the median observation period of 6 yr. Evidently, there is an unexpectedly high prevalence of benign MG in patients with CAH.

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