Beta2-microglobulin predicts survival in primary systemic amyloidosis
Article Abstract:
Studies show that blood levels of the protein beta2-microglobulin are an indicator of the outcome of patients with multiple myeloma, a malignancy characterized by the development of multiple tumors in the bone and bone marrow. Multiple myeloma is associated with anemia, kidney lesions, and elevated blood levels of globulin. Beta2-microglobulin is secreted by plasma cells, and blood levels of this protein may reflect the size of the tumor in multiple myeloma. Primary systemic amyloidosis is a disease of plasma cells, which is similar to myeloma. Both disorders are characterized by the presence of a monoclonal protein (a protein arising from a single cell) in the blood or urine, and bone marrow plasmacytosis (an excess of plasma cells in the bone marrow). The two disorders may coexist in the same patient. One study showed that beta2-microglobulin levels reflected response to treatment in myeloma-associated amyloidosis. The usefulness of beta2-microglobulin levels in predicting survival or response to treatment was assessed in 131 patients with primary systemic amyloidosis without multiple myeloma. The duration of survival was 10.8 months for patients with increased beta2-microglobulin levels, and 32.9 months for patients with normal levels of this protein. When only patients with normal kidney function were considered, survival was 9.1 months in patients with elevated beta2-microglobulin levels and 39.4 months for patients with normal levels. The blood levels of beta2-microglobulin were increased in patients with protein in their urine. These findings suggest that blood levels of beta2-microglobulin may serve as an indicator of outcome in patients with primary systemic amyloidosis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Advances in primary sclerosing cholangitis
Article Abstract:
Primary sclerosing cholangitis (PSC) is a disease of the liver bile ducts and results from cessation of bile excretion. This disorder frequently progresses to cirrhosis, a chronic liver disease, and to death from liver failure. The development of a method to radiologically examine the bile ducts, called endoscopic retrograde cholangiography, has resulted in the increased reporting of this disorder. Each year, 120 cases of PSC are evaluated at the Mayo Clinic, a major medical center in Rochester, Minnesota. The causes of PSC are not known, although infectious, toxic, and immunologic factors have been investigated. PSC is characterized by inflammation, fiber-like growth, and dilatation of the bile ducts, and may be associated with ulcerative colitis, the formation of ulcers in the colon. Patients with ulcerative colitis and increased alkaline phosphatase levels should be screened for PSC. Diagnostic tests include cholangiography and liver biopsy. PSC is treated by correcting deficiencies in fat-soluble vitamins and control of itching. Liver function may deteriorate rapidly due to narrowing of the ducts, gallstones, or cancer of the bile ducts. The outcome of patients with PSC varies, and effective therapy for this disorder has not been established, although possible treatments have been evaluated. Liver transplantation has been the most effective treatment for advanced PSC. Recent studies show that PSC was the third most common diagnosis in patients undergoing liver transplantation, representing 10 to 24 percent of the organ recipients. Knowledge of various aspects of this disorder has increased considerably, and advances in PSC are reviewed. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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