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Serum protein electrophoresis showing a paraprotein (spike/peak in the gamma zone) in a patient with multiple myeloma.. A myeloma protein is an abnormal antibody (immunoglobulin) or (more often) a fragment thereof, such as an immunoglobulin light chain, that is produced in excess by an abnormal monoclonal proliferation of plasma cells, typically in multiple myeloma or Monoclonal gammopathy of ...
(On average, 1%/year.) [15] Typically, a monoclonal gammopathy is malignant or clonal in origin, Myeloma being the most common cause of IgA and IgG spikes. chronic lymphatic leukaemia and lymphosarcoma are not uncommon and usually give rise to IgM paraproteins. Note that up to 8% of healthy geriatric patients may have a monoclonal spike. [16]
Monoclonal gammopathy, also known as paraproteinemia, is the presence of excessive amounts of myeloma protein or monoclonal gamma globulin in the blood. It is usually due to an underlying immunoproliferative disorder or hematologic neoplasms , especially multiple myeloma .
Multiple myeloma is diagnosed based on blood or urine tests finding abnormal antibody proteins (often using electrophoretic techniques revealing the presence of a monoclonal spike in the results, termed an m-spike), bone marrow biopsy finding cancerous plasma cells, and medical imaging finding bone lesions. [6]
Normal blood serum contains a range of antibodies and are said to be polyclonal, whereas serum from a person with plasmacytoma may show a monoclonal spike. This is due to an outgrowth of a single type of plasma cell that forms the plasmacytoma and produces a single type of antibody.
Benign monoclonal gammopathy, monoclonal gammopathy of unknown significance, monoclonal gammopathy of renal significance, [1] unknown or uncertain may be substituted for undetermined: Schematic representation of a normal protein electrophoresis gel. A small spike would be present in the gamma (γ) band in MGUS
Light chain MGUS is defined as a disorder in which a serum κ to λ free light chain ratio falls outside the normal range of 0.26–1.65 (mean =0.9) provided that it is not associated with: a) any of the CRAB criteria, b) a bone marrow plasma cell count of 10 or a higher percentage of nucleated cells, c) evidence of amyloid deposition (see ...
- A. Normal serum - B. Monoclonal intact immunoglobulin IgGλ - C, D. Monoclonal intact immunoglobulin IgDλ and free light chain λ (Fλ). Con. = Conventional electrophoresis staining of the total protein. Immunofixation permits the detection and typing of monoclonal antibodies or immunoglobulins in serum or urine.
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