Mu Heavy Chain Disease Follow-up
- Author: Ajeet Gajra, MD; Chief Editor: Emmanuel C Besa, MD more...
Further Outpatient Care
Once the diagnosis of mu heavy chain disease (mu-HCD) is established, any accompanying lymphoproliferative disorder should be treated. Typically, this involves chemotherapy administered in an outpatient setting.
If no overt lymphoproliferative disorder is found, the patient should be evaluated every few months to assess the abnormal protein. Reasonable follow-up intervals are every 3 months in the first year following diagnosis, every 4 months for the next year, and every 6 months thereafter. The patient should be evaluated earlier if symptoms occur. If the patient is symptomatic in any way, then radiologic assessment and other diagnostic procedures for lymphoproliferative disorders are essential.
See the list below:
- Possible complications include pathologic fracture secondary to osteolytic lesions.
- Renal insufficiency occasionally is associated with mu-HCD. Etiologies include cast glomerulopathy, nodular glomerulosclerosis, and amyloidosis.
- Positive results from a direct antiglobulin test have also been reported.
The clinical course is variable, with survival ranging from 1 month to 11 years after the appearance of symptoms with a median survival of 24 months in the well studied cases. Reports of cures are described, primarily in the setting of a curable lymphoproliferative disorder. Because of its low incidence, no large series of patients treated in a systematic way at a single center has been reported.
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