{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T18:20:17Z","timestamp":1780597217336,"version":"3.54.1"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Gamma heavy chain disease (\u03b3-HCD) is a monoclonal gammopathy defined by an abnormal clonal and isolated production of incomplete heavy chain gamma (\u03b3), unable to bind with light chains kappa or lambda. This disease is rare and remains poorly described. Its association to lymphoid neoplasm is well established, but exceptional forms of \u03b3-HCD may also accompany auto-immune diseases. We report here a new case of \u03b3-HCD characterized by an indolent course with a 4-year follow-up, and its association with quiescent rheumatoid arthritis (RA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We report the case of a 85-year old French white man followed for quiescent anti-CCP+ rheumatoid arthritis treated by prednisolone 4\u00a0mg\/day and hydroxychloroquine 200\u00a0mg\/day since 10 years, and a monoclonal gammopathy of undetermined significance for 6 years, who was hospitalized for costal fractures after a fall. Serum protein electrophoresis showed a stable small monoclonal peak, and capillary electrophoresis\/immunosubtraction technique identified an isolated clonal \u03b3-heavy chain (HC). Bone marrow aspiration was normal and he had no other lymphoproliferation. The monoclonal peak remained stable after 4 years of follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In case of monoclonal peak without complete monoclonal Ig on serum protein electrophoresis, the diagnosis of \u03b3-HCD should be discussed and capillary electrophoresis\/immune-subtraction is a mean to detect isolated monoclonal heavy chain (HC). Gamma-HC disease is rare, may be associated to RA, and may have an indolent course.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-02696-7","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:06:41Z","timestamp":1615939601000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Gamma heavy chain disease associated with rheumatoid arthritis: a\u00a0case report"],"prefix":"10.1186","volume":"15","author":[{"given":"Gwenva\u00ebl","family":"Danic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Dejoie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Caillon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"Achille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Pottier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1156-0607","authenticated-orcid":false,"given":"Christian","family":"Agard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"key":"2696_CR1","first-page":"236","volume":"82","author":"DL Wahner-Roedler","year":"2003","unstructured":"Wahner-Roedler DL, Witzig TE, Loehrer LL, Kyle RA. Gamma-heavy chain disease: review of 23 cases. Medicine (Baltimore). 2003;82:236\u201350.","journal-title":"Medicine (Baltimore)"},{"key":"2696_CR2","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1097\/PAS.0b013e318240590a","volume":"36","author":"S Bieliauskas","year":"2012","unstructured":"Bieliauskas S, Tubbs RR, Bacon CM, Eshoa C, Foucar K, Gibson SE, et al. Gamma heavy-chain disease: defining the spectrum of associated lymphoproliferative disorders through analysis of 13 cases. Am J surg Pathol. 2012;36:534\u201343.","journal-title":"Am J surg Pathol"},{"key":"2696_CR3","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1177\/0004563216646594","volume":"53","author":"WI Deighan","year":"2016","unstructured":"Deighan WI, O\u2019Kane MJ, McNicholl FP, Keren DF. Multiple Myeloma and multiple plasmacytomas associated with free gamma heavy chain, free kappa light chain and IgGk paraproteins: an unusual triple gammopathy. Ann Clin biochem. 2016;53:706\u201311.","journal-title":"Ann Clin biochem"},{"key":"2696_CR4","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1179\/1607845415Y.0000000037","volume":"21","author":"A Wahbi","year":"2016","unstructured":"Wahbi A, N\u00e9el A, Perrin F, Graveleau J, Mah\u00e9 B, Dejoie T, et al. Gamma heavy chain disease associated with large granular lymphocytic leukemia: a report of two cases and review of the literature. Hematology. 2016;21:92\u20134.","journal-title":"Hematology"},{"key":"2696_CR5","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/0049-0172(89)90045-0","volume":"18","author":"JR Dickson","year":"1989","unstructured":"Dickson JR, Harth M, Bell DA, Komar R, Chodirker WB. Gamma heavy chain disease and rheumatoid arthritis. Semin Arthritis Rheum. 1989;18:247\u201351.","journal-title":"Semin Arthritis Rheum"},{"key":"2696_CR6","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1080\/030097498440750","volume":"27","author":"GP Husby","year":"1998","unstructured":"Husby GP, Blichfeldt P, Brinch L, Brandtzaeg P, Mellbye OJ, Sletten K, et al. Chronic arthritis and gamma heavy chain disease: coincidence or pathogenic link? Scand J Rheumatol. 1998;27:257\u201364.","journal-title":"Scand J Rheumatol"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-02696-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13256-021-02696-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-02696-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:31:06Z","timestamp":1615941066000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-021-02696-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,17]]},"references-count":6,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2696"],"URL":"https:\/\/doi.org\/10.1186\/s13256-021-02696-7","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,17]]},"assertion":[{"value":"18 March 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This work has been performed in accordance with the Declaration of Helsinki.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"121"}}