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Am. J. Trop. Med. Hyg., 81(4), 2009, pp. 660-664
doi:10.4269/ajtmh.2009.09-0063;
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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Clinical Course of Monoclonal and Oligoclonal Gammopathies in Patients Infected with Orientia tsutsugamushi

Do-Sim Park*, Ji-Hyun Cho, Jae-Hoon Lee, AND Key-Earn Lee
Department of Laboratory Medicine and Division of Infectious Disease, Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea; Department of Laboratory Medicine, Kunsan Medical Center, Wonkwang University School of Medicine, Iksan, Republic of Korea

Although we have encountered many cases of monoclonal gammopathies (MGs) or oligoclonal gammopathies (OGs) in patients with Orientia tsutsugamushi infections, the clinical course of MG/OG associated with these infections has rarely been reported. We serially monitored 18 cases of MG/OG that appeared in the acute phase or early convalescent phase of scrub typhus. All MGs/OGs associated with infection with O. tsutsugamushi disappeared 7–15 weeks after treatment with doxycycline. In three cases of scrub typhus, MGs/OGs appeared before seropositive conversion (presence of antibodies against O. tsutsugamushi) and disappeared before seronegative conversion. Understanding our cases may be helpful for relevant clinical counseling and making appropriate medical decisions to avoid unnecessary invasive or cost-intensive diagnostic procedures for MGs/OGs in scrub typhus, especially in disease-endemic areas. We also suggest that 2–4 months after antibiotic treatment might be the optimal follow-up time to observe the disappearance of MGs/OGs associated with O. tsutsugamushi infections.

Received January 31, 2009. Accepted for publication July 5, 2009.

Financial support: This study was supported by Wonkwang University Research Grant 2009.

* Address correspondence to Do-Sim Park, Department of Laboratory Medicine, School of Medicine, Wonkwang University, 344-2 Shinyongdong, Iksan, Jeonbuk 570-749, Republic of Korea. E-mail: email{at}wku.ac.kr

Authors’ addresses: Do-Sim Park and Ji-Hyun Cho, Department of Laboratory Medicine, School of Medicine, Wonkwang University, 344-2 Shinyong-dong, Iksan, Jeonbuk 570-749, Republic of Korea, E-mails: email{at}wku.ac.kr and cjh{at}wku.ac.kr. Jae-Hoon Lee, Division of Infectious Disease, Department of Internal Medicine, School of Medicine, Wonkwang University, 344-2 Shinyong-dong, Iksan, Jeonbuk 570-749, Republic of Korea, Tel: 82-63-839-9392, E-mail: john7026{at}wku.ac.kr. Key-Earn Lee, Department of Laboratory Medicine, School of Medicine, Wonkwang University, 29-1 Geekokdong, Kunsan, Jeonbuk 573-713, Republic of Korea, E-mail: gelee{at}wku.ac.kr.






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Copyright © 2009 by the American Society of Tropical Medicine and Hygiene.