Characterization of Monoclonal Gammopathies by Electrophoresis in a Rural population of Manabí, Ecuador
Keywords:
protein electrophoresis; immunotyping; monoclonal gammopathy; agrochemicals.Abstract
Introduction: The combination of protein electrophoresis and immunotyping is highly useful in the diagnosis of plasma cell dyscrasias. The causes of these diseases are unknown, and they may be associated with the use of agrochemicals. Malignant diseases such as multiple myeloma are preceded by monoclonal gammopathy of undetermined significance. If diagnosed early, monitoring could be carried out and complications could be prevented following the guidelines of the International Working Group on Myeloma.
Objective: To describe monoclonal components in the blood of residents of rural areas of Manabí, Ecuador.
Methods: An observational, descriptive and retrospective study was conducted among 410 residents over 35 years of age from October 2023 to January 2024.
Results: The population was predominantly montubio farmers aged 49–55, males who used agrochemicals in their daily work. Seventy-four percent of the protein electrophoreses performed were pathological and 61 % showed abnormalities in the gamma globulin fraction. Twenty-two immunotyping tests were performed, 14 corresponded to the IgG Kappa isotype, and 4 results were observed with more than one associated clone.
Conclusions: Monoclonal components found in this population should be monitored to diagnose a potentially malignant monoclonal gammopathy in a timely manner.
Keywords: protein electrophoresis; immunotyping; monoclonal gammopathy; agrochemicals.
Downloads
References
1. Jain A, Haynes R, Kothari J, Khera A, Soares M, Ramasamy K. Pathophysiology and management of monoclonal gammopathy of renal significance. Blood Adv. 2019 [acceso 30/10/2024];3(15):2409-23. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31409583/
2. Callander NS, Baljevic M, Adekola K, Anderson LD, Campagnaro E, Castillo JJ, et al. NCCN Guidelines® Insights: Multiple Myeloma, Version 3.2022. J Natl Compr Cancer Netw JNCCN. 2022 [acceso 30/10/2024];20(1):8-19. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34991075/
3. Kaseb H, Annamaraju P, Babiker HM. Monoclonal Gammopathy of Undetermined Significance. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [acceso 30/10/2024]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK507880/
4. Gamapatía monoclonal de significado incierto | Sobre la enfermedad | GARD. [acceso 23/10/2024]. Disponible en: https://rarediseases.info.nih.gov/espanol/12572/gamapatia-monoclonal-de-significado-incierto
5. Cairo-Martínez JC, Howland-Álvarez I, Fosado-Téllez OA, Ponce-Ibarra YP, Solórzano-Andrade ME, Campos-García GA. Cadenas ligeras libres en sangre de sujetos de zonas rurales de la provincia Manabí, Ecuador. Rev Méd Electrón. 2025 [acceso 25/03/2024];47:e6288. Disponible en: https://revmedicaelectronica.sld.cu/index.php/rme/article/view/6288
6. Análisis del nuevo plan económico de Ecuador. IMF. [acceso 30/10/2024]. Disponible en: https://www.imf.org/es/News/Articles/2019/03/20/NA032119-Ecuador-New-Economic-Plan-Explained
7. Pinargote DT, Cedeño AZ, Fernández-Aballí LS, García GAC, Álvarez IH. Inmunotipificación y cuantificacion de cadenas ligeras libres en pacientes ecuatorianos con Gammapatías monoclonales. Rev Ecuat Med Cienc Biológicas. 2021 acceso [acceso 25/03/2024];42(2). Disponible en: https://remcb-puce.edu.ec/remcb/article/view/905
8. Pretorius CJ. Screening immunofixation should replace protein electrophoresis as the initial investigation of monoclonal gammopathy: Point. Clin Chem Lab Med. 2016 [acceso 25/03/2024];54(6):963-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26574893/
9. Keren DF, Bocsi G, Billman BL, Etzell J, Faix JD, Kumar S, et al. Laboratory Detection and Initial Diagnosis of Monoclonal Gammopathies. Arch Pathol Lab Med. 2022 [acceso 25/03/2024];146(5):575-90. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34347866/
10. Lee N, Jeong S, Jeon K, Song W, Park MJ. Development and validation of a deep learning-based protein electrophoresis classification algorithm. PLOS ONE. 2022 [acceso 25/03/2024];17(8):e0273284. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36001575/
11. Kuriakose E, Narayanan Unni Cheppayil S, Kuzhikandathil Narayanan S, Vasudevan A. A Study on Free Light Chain Assay and Serum Immunofixation Electrophoresis for the Diagnosis of Monoclonal Gammopathies. Indian J Clin Biochem IJCB. 2019 [acceso 25/03/2024];34(1):76-81. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30728676/
12. World Medical Assocition Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA. 2013;310(20):1-95. DOI: https://doi.org/10.1001/jama.2013.281053
13. Alejo E, Puertas B, Mateos MV. Gammapatía monoclonal de significado incierto. Med Clínica. 2023 [acceso 25/03/2024];161(5):217-24. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=9061846
14. Han J hua, Wang J nuo, Zhang Y lun, Cao X xin, Zhou D bin, Xu T da, et al. Prevalence of monoclonal gammopathy of undetermined significance in a large population with annual medical check-ups in China. Blood Cancer J. 2020 [acceso 25/03/2024];10(3):34. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC7062721/
15. El-Khoury H, Lee DJ, Alberge JB, Redd R, Cea-Curry CJ, Perry J, et al. Prevalence of monoclonal gammopathies and clinical outcomes in a high-risk US population screened by mass spectrometry: a multicentre cohort study. Lancet Haematol. 2022 [acceso 25/03/2024];9(5):e340-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35344689/
16. Leone PE, Cabrera-Andrade A, García-Cárdenas JM, González DA, Guevara-Ramírez P, López-Cortés A, et al. Ancestry study in Ecuadorian population with multiple myeloma. Forensic Sci Int Genet Suppl Ser. 2017 [acceso 25/03/2024];6:e435-6. Disponible en: https://www.academia.edu/81716113/MIELOMA_M%C3%9ALTIPLE_EN_COLOMBIA
17. Sector rural: el 77,9 % de trabajadores tiene un empleo no adecuado. [acceso 30/10/2024]. Disponible en: https://www.primicias.ec/noticias/economia/autoempleo-predomina-pequena-agricultura/
18. Cohecha AKC, Niño SVM, De Arco OC. Efectos en la salud de los agricultores latinoamericanos expuestos a plaguicidas: una revisión sistemática 1991-2018. | EBSCOhost. 2021 [acceso 30/10/2024];38:22. Disponible en: https://openurl.ebsco.com/contentitem/gcd:151796250?sid=ebsco:plink:crawler&id=ebsco:gcd:151796250
19. Marinkovic A, Zypchen LN, Chan J, Chen LY, Parkin S. Monoclonal gammopathy of clinical significance: what the rheumatologist needs to know. Lancet Rheumatol. 2022 May;4(5):e362-e373. DOI: https://doi.org/10.1016/S2665-9913(21)00348-9
20. Rasel M, Zahra F. Hypergammaglobulinemia (Polyclonal Gammopathy). En: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 [acceso 31/10/2024]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK585137/
21. Salamatmanesh M, McCudden CR, McCurdy A, Booth RA. Monoclonal protein reference change value as determined by gel-based serum protein electrophoresis. Clin Biochem. 2018 [acceso 31/10/2024];51:61-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29079358/
22. Ullah A, Omar N, Savage NM, Bollag RJ, Singh G. Immune subtraction for improved resolution in serum protein immunofixation electrophoresis and antibody isotype determination in a patient with autoantibody. Pract Lab Med. 2021 [acceso 31/10/2024];26:e00240. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34124325/
23. Iceland screens, treats, or prevents multiple myeloma (iStopMM): a population-based screening study for monoclonal gammopathy of undetermined significance and randomized controlled trial of follow-up strategies | Blood Cancer Journal. [acceso 31/10/2024]. Disponible en: https://www.nature.com/articles/s41408-021-00480-w
24. Estruch EB, López MAC. Mieloma múltiple: nuevas recomendaciones. Sociedad española de medicina de laboratorio. 2021 [acceso 31/10/2024]. Disponible en: https://www.seqc.es/download/tema/38/7585/85888673/641274/cms/tema-1-mieloma-multiple-nuevas-recomendaciones.pdf/
25. Rögnvaldsson S, Love TJ, Thorsteinsdottir S, Reed ER, Óskarsson JÞ, Pétursdóttir Í, et al. Iceland screens, treats, or prevents multiple myeloma (iStopMM): a population-based screening study for monoclonal gammopathy of undetermined significance and randomized controlled trial of follow-up strategies. Blood Cancer J. 2021 [acceso 31/10/2024];11(5):1-13. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34001889/
26. Genzen JR, Murray DL, Abel G, Meng QH, Baltaro RJ, Rhoads DD, et al. Screening and Diagnosis of Monoclonal Gammopathies: An International Survey of Laboratory Practice. Arch Pathol Lab Med. 2018 [acceso 31/10/2024];142(4):507-15. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29266967/
27. Katzmann JA, Kyle RA, Benson J, Larson DR, Snyder MR, Lust JA, et al. Screening panels for detection of monoclonal gammopathies. Clin Chem. 2009 [acceso 31/10/2024];55(8):1517-22. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19520758/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Ana Lucía Cedeño Solórzano , Jorge Grisaldo Zambrano Mera , Jhon Willian Córdova Zambrano, Kevin Edgar Solórzano Cedeño, Jorge César Cairo Martínez, Ivón Howland Álvarez
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The Cuban Journal of Medicine protects the author's patrimonial rights. However, it is licensed under a Creative Commons Licensehttps://creativecommons.org/licenses/by-nc/4.0/deed.es_ES which permits unrestricted non-commercial use, distribution and reproduction in any medium, provided that the primary source of publication is duly cited. The author always retains his moral rights.
You are free to:
- Share - copy and redistribute the material in any medium or format.
- Adapt - remix, transform and build upon the material
- The license cannot revoke these freedoms as long as you follow the terms of the license.
Under the following terms:
- Attribution - You must give proper credit, provide a link to the license, and indicate if changes have been made. You may do so in any reasonable manner, but not in such a way as to suggest that you or your use is supported by the licensor.
- Non-Commercial Purpose- You may not make use of the material for commercial purposes.
- No Additional Restrictions - You may not apply legal terms or technological measures that legally restrict others from making any use permitted by the license.
