In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 10 ( 2022-10-31), p. e0276048-
Abstract:
To determine prevalence of paraproteinemic keratopathy (PPK) among patients with monoclonal gammopathy (MG). To evaluate interrelation between corneal and hematological parameters in patients with PPK. Methods Fifty-one patients with monoclonal gammopathy of undetermined significance (n = 19), smoldering multiple myeloma (n = 5) or multiple myeloma (n = 27) were prospectively included in this study. Best-corrected visual acuity, slit-lamp biomicroscopy, Scheimpflug tomography, in-vivo confocal laser scanning microscopy, optical coherence tomography and complete hematological workup were assessed. Results We identified n = 19 patients with bilateral corneal opacities compatible with PPK. PPK was newly diagnosed in 13 (29%) of 45 patients with a primary hematological diagnosis and in n = 6 patients without previous hematological diagnosis. The most common form was a discreet stromal flake-like PPK (n = 14 of 19). The median level of M-protein (p = 0.59), IgA (p = 0.53), IgG (p = 0.79) and IgM (p = 0.59) did not differ significantly between the patients with and without PPK. The median level of the FLC κ in serum of patients with kappa-restricted plasma cell dyscrasia was 209 mg/l in patients with PPK compared to 38.1 mg/l in patients without PPK (p = 0.18). Median level of FLC lambda in serum of patients with lambda-restricted plasma cell dyscrasia was lower in patients with PPK compared to patients without PPK (p = 0.02). Conclusion The PPK was mostly discreet, but its prevalence (29%) was higher than expected. Median level of the monoclonal paraprotein was not significantly higher in patients with PPK compared to patients without PPK. Our results suggest a lack of correlation between morphology and severity of the ocular findings and severity of the monoclonal gammopathy. Trial registration German Clinical Trial Register: DRKS00023893 .
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0276048
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10.1371/journal.pone.0276048.g001
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10.1371/journal.pone.0276048.g002
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10.1371/journal.pone.0276048.g003
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10.1371/journal.pone.0276048.t001
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10.1371/journal.pone.0276048.t002
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10.1371/journal.pone.0276048.t003
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10.1371/journal.pone.0276048.t004
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10.1371/journal.pone.0276048.s001
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10.1371/journal.pone.0276048.s002
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10.1371/journal.pone.0276048.s003
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10.1371/journal.pone.0276048.s004
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10.1371/journal.pone.0276048.s005
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10.1371/journal.pone.0276048.s006
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10.1371/journal.pone.0276048.s007
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10.1371/journal.pone.0276048.s008
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10.1371/journal.pone.0276048.s009
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10.1371/journal.pone.0276048.s010
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10.1371/journal.pone.0276048.s011
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10.1371/journal.pone.0276048.r001
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10.1371/journal.pone.0276048.r002
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10.1371/journal.pone.0276048.r003
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10.1371/journal.pone.0276048.r004
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10.1371/journal.pone.0276048.r005
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10.1371/journal.pone.0276048.r006
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10.1371/journal.pone.0276048.r007
DOI:
10.1371/journal.pone.0276048.r008
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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