Progression of IgA gammopathy to myeloma following infliximab treatment for pyoderma gangrenosum

Shareef, Mohammed; Munro, Laura; Owen, Roger G.; Highet, A.S.

doi:10.1111/j.1365-2230.2011.04219.x

Cited by 12 publications

(5 citation statements)

References 11 publications

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“…A total of 3212 unique citations were found. 1286 and 1704 citations were excluded by abstract and full‐text read, respectively, yielding 222 articles…”

Section: Resultsmentioning

confidence: 99%

Pyoderma gangrenosum and tumour necrosis factor alpha inhibitors: A semi‐systematic review

Abdallah

Fogh

Bech

2019

International Wound Journal

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Pyoderma gangrenosum (PG) is a rare ulcerative skin disease that presents a therapeutic challenge. Tumour necrosis factor alpha (TNFα) inhibitors have been reported to successfully control PG. Our aim was to systematically evaluate and compare the clinical effectiveness of TNFα inhibitors in adults with PG. A literature search including databases such as PubMed, Embase, Scopus, and Web of Science was conducted, using search terms related to PG and TNFα inhibitors. Studies and case reports were included if patients were diagnosed with PG, over the age of 18 and administered TNFα inhibitor. A total of 3212 unique citations were identified resulting in 222 articles describing 356 patients being included in our study. The study we report found an 87% (95% CI: 83%‐90%) response rate and a 67% (95% CI: 62%‐72%) complete response rate to TNFα inhibitors. No statistically significant differences in the response rates (P = 0.6159) or complete response rates (P = 0.0773) to infliximab, adalimumab, and etanercept were found. In our study TNFα inhibitors demonstrated significant effectiveness with response and complete response rates supporting the use of TNFα inhibitors to treat PG in adults. Our study suggests that there is no significant difference in effectiveness among infliximab, adalimumab, and etanercept.

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“…A total of 3212 unique citations were found. 1286 and 1704 citations were excluded by abstract and full‐text read, respectively, yielding 222 articles…”

Section: Resultsmentioning

confidence: 99%

Pyoderma gangrenosum and tumour necrosis factor alpha inhibitors: A semi‐systematic review

Abdallah

Fogh

Bech

2019

International Wound Journal

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“…The severity of MM did not change during adalimumab therapy. Another case presented progression from underlying MGUS to myeloma, following infliximab treatment for pyoderma gangrenosum 19. Therefore, further studies on the relationship between TNF-α blockage and MM progression are required.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is no study reporting the meaning of MM Ig subtype in CD patients. Shareef et al19 reported a case of progression from underlying IgA subtype MGUS to myeloma, following infliximab treatment for pyoderma gangrenosum, and not for CD. However, this case was different from our case, as pre-existing IgA gammopathy progression to myeloma rather than IgA subtype myeloma was caused by infliximab.…”

Section: Discussionmentioning

confidence: 99%

Crohn's disease and smoldering multiple myeloma: a case report and literature review

et al. 2017

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Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) that presents with abdominal pain, weight loss, and diarrhea. Although the etiology has not been fully elucidated, both environmental and genetic causes are known to be involved. In chronic inflammatory conditions such as IBD, B lymphocytes are chronically stimulated, and they induce monoclonal expansion of plasma cells, sometimes resulting in monoclonal gammopathy of undetermined significance. Immunomodulators that are commonly used to control inflammation, such as tumor necrosis factor-α (TNF-α) blockers could increase the possibility of hematologic malignancy. The pathogenesis of multiple myeloma in association with TNF-α inhibitor therapy is attributed to decreased apoptosis of plasma cell populations. Here, we describe a case of a 36-year-old male patient who was diagnosed with immunoglobulin A subtype smoldering multiple myeloma during the treatment for CD with infliximab and adalimumab. We report this case along with a review of the literature on cases of multiple myeloma that occurred in conjunction with CD.

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“…Biological agents, like infliximab, show promising efficacy with PG. However, their use should be restricted in patients with monoclonal gammopathy since biological agents may promote flare-up of M-protein [ 165 , 166 ]. Mycophenolate mofetil, cyclophosphamide, danazol, IL-1 inhibitors (anakinra and canakinumab), and azathioprine are options for patients with refractory PG [ 167 – 169 ].…”

Section: Group IImentioning

confidence: 99%

Cutaneous manifestations of monoclonal gammopathy

2022

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Monoclonal gammopathy associated with dermatological manifestations are a well-recognized complication. These skin disorders can be associated with infiltration and proliferation of a malignant plasma cells or by a deposition of the monoclonal immunoglobulin in a nonmalignant monoclonal gammopathy. These disorders include POEMS syndrome, light chain amyloidosis, Schnitzler syndrome, scleromyxedema and TEMPI syndrome. This article provides a review of clinical manifestations, diagnostics criteria, natural evolution, pathogenesis, and treatment of these cutaneous manifestations.

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Progression of IgA gammopathy to myeloma following infliximab treatment for pyoderma gangrenosum

Cited by 12 publications

References 11 publications

Pyoderma gangrenosum and tumour necrosis factor alpha inhibitors: A semi‐systematic review

Pyoderma gangrenosum and tumour necrosis factor alpha inhibitors: A semi‐systematic review

Crohn's disease and smoldering multiple myeloma: a case report and literature review

Cutaneous manifestations of monoclonal gammopathy

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