Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease which is characterized by the involvement of the sacroiliac joint and the spine, the main therapy includes biological agents, which may increas...Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease which is characterized by the involvement of the sacroiliac joint and the spine, the main therapy includes biological agents, which may increase the risk of tumor and infection in long term application. Case Presentation: A fifty-year- old man was diagnosed of AS. He received the therapy of golimumab 50 mg once every one month subcutaneously. After receiving this treatment for two years and eight months, the patient had an elevated level of IgA. The monoclonal protein was finally identified as the type of IgA-kappa from the immunofixation study. Bone marrow aspirate smear revealed infiltration by plasma cells (5%) and immunophenotyping was positive for CD27, CD28, CD38, CD45, CD138 and cKappa, which was finally diagnosed of MGUS. Conclusion: This case demonstrates that golimumab may increase the risk of premalignant disease in patients with AS. With our case report, we also like to highlight that patients with AS may have increased risk of plasma cell malignancies.展开更多
文摘Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease which is characterized by the involvement of the sacroiliac joint and the spine, the main therapy includes biological agents, which may increase the risk of tumor and infection in long term application. Case Presentation: A fifty-year- old man was diagnosed of AS. He received the therapy of golimumab 50 mg once every one month subcutaneously. After receiving this treatment for two years and eight months, the patient had an elevated level of IgA. The monoclonal protein was finally identified as the type of IgA-kappa from the immunofixation study. Bone marrow aspirate smear revealed infiltration by plasma cells (5%) and immunophenotyping was positive for CD27, CD28, CD38, CD45, CD138 and cKappa, which was finally diagnosed of MGUS. Conclusion: This case demonstrates that golimumab may increase the risk of premalignant disease in patients with AS. With our case report, we also like to highlight that patients with AS may have increased risk of plasma cell malignancies.
