Systemic Disorders With Rheumatic ManifestationsIs there a pathogenic link between gamma heavy chain disease and chronic arthritis?Husby, Gunnar MD, PhD Author Information Center for Rheumatic Diseases, The National Hospital, University of Oslo, Oslo, Norway Correspondence to Gunnar Husby, Center for Rheumatic Diseases, The National Hospital, University of Oslo, 0027 Oslo, Norway; e-mail: [email protected] Current Opinion in Rheumatology: January 2000 - Volume 12 - Issue 1 - p 65-70 Buy Abstract In 1991, γ heavy chain disease was diagnosed in a 43-year-old female, who 3 years earlier had contracted an erosive seronegative chronic arthropathy. In 1996, her lymphoproliferative disorder required treatment with melphalan and prednisolone. Laboratory studies revealed a γ3 heavy chain monoclonal component in serum and urine. Massive localization of plasma cells and blasts with cytoplasmic or cell membrane staining for γ3 chains, but no staining for light chains, was observed by immunohistochemical studies of bone marrow as well as affected synovial tissue. Large amounts of extracellular γ3-chains were also deposited in the synovial membrane. This is the first documentation of γ heavy chain deposition disease directly affecting articular structures. Whether it represents the primary pathogenic event followed by reactive inflammatory changes in the joints, or another example of γ heavy chain disease preceded by chronic arthritis, remains elusive. Regardless, several common cellular and molecular mechanisms discussed here suggest a pathogenic link between the two disease processes. © 2000 Lippincott Williams & Wilkins, Inc.