Multiple Myeloma type of immune defect - USMLE Forums
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Old 06-06-2011
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Immunology Multiple Myeloma type of immune defect

In MM there is a bigger chance of infection, right? So the patient does not produce enough immunoglobulin (monoclonal gammopathy). Would it be a opsonization defect?
Please, correct me if I am wrong
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Old 06-06-2011
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That's definitely part of it. The following is a more detailed answer from UpToDate:

Multiple myeloma (MM) arises from a malignant transformation of a B cell that permits it to differentiate into an antibody-producing cell independent of the stimuli normally required for this process.

A number of immunologic abnormalities may be found at diagnosis, possibly resulting in infection as the presenting symptom:

The number of CD4 positive T cells is decreased, CD8 suppressor cells may be increased, and the CD4/CD8 ratio is frequently less than one. These findings are not specific, and may be observed in other plasma cell dyscrasias and hematologic malignancies.

Although the level of serum immunoglobulin is often increased by virtue of the M (monoclonal) component, the ability to produce effective antibody responses is reduced. These patients have hypogammaglobulinemia if the contribution of the M component is not considered. This may be associated with a decrease in circulating B cells which bear the same immunoglobulin light chain isotype as the myeloma.

Poorly characterized deficits in complement activation and in neutrophil function contribute to the increased risk of infection with S. pneumoniae and other encapsulated organisms.

Chemotherapy for MM is associated with additional risk of gram-negative sepsis and opportunistic infections. In one survey of fatalities in MM, documented or suspected infection was responsible for 42 percent. Of the 22 cases in which an organism was identified, 9 (41 percent) had gram-positive infection; 6 (28 percent) gram-negative (mainly E. coli) infection; and 2 (9 percent) fungal disease. The remaining patients had infections due to anaerobic bacteria, M. tuberculosis, or viruses, or polymicrobial infection.

Pneumococcal vaccine is recommended at diagnosis, with penicillin prophylaxis if the response is inadequate.
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Old 06-07-2011
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While there is an excess amount of immunoglobins (IgG, IgA) in the case of Multiple Myeloma, these Igs are not functional as i remember.
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Infectious-Diseases, Internal-Medicine-, Oncology-

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