Hepatitis C Positive Patients in Relation to Polyclonal and Monoclonal Gammopathy: An Egyptian Experience

Abstract Background: Gammapathies is one of long term compli-cation of chronic HCV Infection B-cell lymphoproliferative diseases produced by a clonal proliferation of plasma cells producing a unique immunoglobulin are known as monoclonal gammopathies. Their clinical spectrum includes monoclonal gammopathy of undetermined significance (MGUS) and overt multiple myeloma. Aim of Study: The present study aimed to examine the prevalence, characteristics, and predictors of gammopathies in Egyptian patients with chronic HCV infection. Patients and Methods: This study conducted a prospective cohort study on patients with bilateral baggy lower eyelids who underwent traditional lower blepharoplasty with fat excision or fat-sparing technique using the orbital septal plication method. Results: The study was performed on 40 patients (20 patients per group). The right medial OGS showed a significant reduction in the fat-sparing and traditional groups (p<0.001, each). However, the percentage of reduction was significantly higher in the fat-sparing group (35.8±2.8 versus 14.6±3.4 in the traditional groups; p<0.001). Likewise, the left medial OGS showed a significant reduction in the fat-sparing and traditional groups (p<0.001, each). The percentage of reduction was significantly higher in the fat-sparing group (35.9±2.9 versus 14.7±3.3 in the traditional groups; p<0.001). Both left and right-sided central and lateral OGS showed a significant reduction in the fat-sparing and traditional groups (p<0.001, each). However, the percentage of reduction was significantly higher in the fat-sparing group (p<0.001, each). Conclusion: In conclusion, the prevalence of polyclonal gammopathy was higher in patients with chronic HCV com-pared with monoclonal, which is reported to be related to old age. Patients with gammopathy were associated with anemia, altered coagulation profile, high alfa-fetoprotein, low albumin level, and leukocytosis. Enlarged spleen, male gender, WBCS <5.000cc/mm3, and platelets below 120.000 are significant predictors of gammopathy in patients with chronic HCV.