Overview.
Plasmacytosis, or reactive plasmacytosis. Intramedullary plasmacytosis (Plasmacytosis) can occur in different extramedullary immunoproliferative pathologies such as antigenic stimulation, allergic reactions, autoimmunity, and small intestinal immunoproliferative disorders. Under normal conditions, plasma cells do not appear in the peripheral blood, but they can appear in pathological conditions, increasing in the bone marrow and lymph nodes and other lymphoid tissues.
Etiology
Common causes include viral infections, allergic diseases, connective tissue diseases, tuberculosis and other chronic infectious diseases, chronic liver disease, malignant tumors, aplastic anemia, granulocyte deficiency, myelodysplastic syndromes, and other hematopoietic disorders.
Symptoms
Related to the primary disease, it may cause manifestations such as hemolytic anemia, acquired vascular hemophilia, or hypoglycemia.
Examination
1. Serum immunologic examination
Immunoglobulin is normal or polyclonal increase, with IgG increase being more common.
2. Bone marrow cytology
Bone marrow plasma cell increase >3%, but often <15%, usually mature plasma cells, a small number of patients can be significantly increased plasma cells.
Diagnosis
1. Reactive plasma cell dyscrasia has a cause or primary disease, the common ones are: viral infection, allergic disease, connective tissue disease, tuberculosis and other chronic infectious diseases, chronic liver disease, malignant tumor, aplastic anemia, granulocyte deficiency, myelodysplastic syndrome and other hematopoietic system diseases.
2. Clinical manifestations are related to the primary disease.
3. Immunoglobulin is normal or increased, and immunofixation electrophoresis shows polyclonality.
4. >3% plasma cell increase in the bone marrow, which is mature plasma cells.
5. Exclude multiple myeloma, extramedullary plasmacytoma, macroglobulinemia, heavy chain disease, and primary amyloidosis.
Treatment
Treat the primary disease and remove the cause. When causing hemolytic anemia, acquired vascular hemophilia, hypoglycemia, adrenocorticotropic hormone or other immunosuppressant treatment can be tried.
Prognosis
The improvement of reactive plasmacytosis depends on the treatment effect of the primary disease, and the plasmacytosis may disappear only after the primary disease is cured.