II. Findings: Monoclonal Gammopathy (M-Spike)
-
General
- Paraprotein peak present (Paraproteinemia)
- Associated with malignancy
- Sharp spike M-Band
- Contrast with broad polyclonal band (see below)
- Causes
- Multiple Myeloma
- Narrow M-Protein spike >3 g/dl
- Lytic skeletal lesions, Pancytopenia, Renal Failure
- Monoclonal Gammopathy of Undetermined Significance (MGUS)
- Benign Paraproteinemia (essential Paraproteinemia)
- Waldenstrom Macroglobulinemia
- M Protein: IgM
- Hyperviscosity and hypercellular Bone Marrow
- Plasmacytoma
- Amyloidosis
- Plasma cell Leukemia
- M-Protein: Low levels
- Peripheral blood with >20% plasma cells
- Franklin Disease (Heavy chain disease)
- M Protein
- Heavy chain incomplete
- Light chain absent
- M Protein
- Multiple Myeloma
III. Findings: Polyclonal Gammopathy
-
General
- Broad diffuse band
- Contrast with sharp spike M-Band in monoclonal
- Most often represents non-malignant causes
- Contrast with malignancy in monoclonal
- Broad diffuse band
- Causes
- Infection
- Viral Infection (HIV, Hepatitis, EBV, VZV)
- Endocarditis
- Osteomyelitis
- Tuberculosis
- Connective Tissue Disease
- Liver disease
- Cirrhosis
- Hepatitis
- Primary Biliary Cirrhosis
- Malignancy
- Hematologic disorder
- Inflammatory condition
- Thyroid disorder
- Infection
IV. Findings: Interpretation of Monoclonal Protein Spike
- M-Spike < 1.5 g/dl
- Repeat Serum Protein Electrophoresis in one year
- M-Spike 1.5 to 2.5 g/dl
- Nephelometry to quantify Immunoglobulins
- 24 hour urine for electrophoresis and immunofixation
- M-Spike >2.5 g/dl
- Bone survey of Humerus and femur for metastases
- Bone Marrow Biopsy
- Abdominal CT
- Beta-2 microglobulin level
- C-Reactive Protein
- 24 hour urine for electrophoresis and immunofixation
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Definition (NCI) | A plasma cell disorder in which an abnormal amount of a single immunoglobulin is present in the serum. Paraproteinemias may be seen in conjunction with various carcinomas, chronic inflammatory and infectious conditions, and other diseases. --2004 |
Definition (MSH) | A group of related diseases characterized by an unbalanced or disproportionate proliferation of immunoglobulin-producing cells, usually from a single clone. These cells frequently secrete a structurally homogeneous immunoglobulin (M-component) and/or an abnormal immunoglobulin. |
Concepts | Disease or Syndrome (T047) |
MSH | D010265 |
SnomedCT | 278501001, 190816000, 35601003, 123061006 |
English | Paraimmunoglobulinemia, Paraimmunoglobulinemias, Paraproteinemias, Paraproteinaemia NOS, Paraproteinemia NOS, Paraproteinemias [Disease/Finding], paraproteinemias, paraproteinemia, paraproteinaemia, Paraproteinemia NOS (disorder), Paraproteinemia (disorder), Paraproteinemia, Paraproteinaemia |
Italian | Paraproteinemia, Paraproteinemia NAS, Paraproteinemie |
Dutch | paraproteïnemie NAO, paraproteïnemie, Para-immunoglobulinemie, Paraproteïnemie, Paraproteïnemieën, Proteïnemieën, para-, Proteïnemie, para- |
French | Paraprotéinémie SAI, Paraprotéinémie, Paraprotéinémies |
German | Paraproteinaemie NNB, Paraproteinaemie, Paraimmunglobulinämien, Paraproteinämien |
Portuguese | Paraproteinemia NE, Paraproteinemia, Paraimunoglobulinemias, Paraproteinemias |
Spanish | Paraproteinemia NEOM, paraproteinemia (trastorno), paraproteinemia, SAI (trastorno), paraproteinemia, SAI, Gamapatías Monoclonales, Gammapatías Monoclonales, Gamopatías Monoclonales, paraproteinemia, Paraproteinemia, Parainmunoglobulinemias, Paraproteinemias |
Japanese | パラプロテイン血症NOS, パラプロテインケツショウNOS, パラプロテインケツショウ, パラプロテインケッショウ, パラプロテインケッショウNOS, 形質細胞障害, パラプロテイン血症, 異種蛋白血症, 単クローン性免疫グロブリン血症, 異常たんぱく血症, パラプロテイン血, 単クローン性ガンマグロブリン血症, パラプロテイネミア, モノクローナルガンマグロブリン血症, パラ免疫グロブリン血症, モノクローナル免疫グロブリン血症, 異常蛋白血症, M蛋白血症, 異常蛋白質血症 |
Swedish | Paraproteinemier |
Czech | paraproteinémie, Paraproteinemie, Paraproteinemie NOS |
Finnish | Paraproteinemiat |
Russian | GAMMAPATII MONOKLONAL'NYE, PARAIMMUNOGLOBULINEMIIA, PARAPROTEINEMIIA, PLAZMATICHESKIKH KLETOK DISKRAZIIA, ГАММАПАТИИ МОНОКЛОНАЛЬНЫЕ, ПАРАИММУНОГЛОБУЛИНЕМИЯ, ПАРАПРОТЕИНЕМИЯ, ПЛАЗМАТИЧЕСКИХ КЛЕТОК ДИСКРАЗИЯ |
Croatian | PARAPROTEINEMIJA |
Polish | Paraproteinemie |
Hungarian | Paraproteinaemia k.m.n., Paraproteinaemia, Paraproteinemia |
Norwegian | Paraproteinemier |
Ontology: Monoclonal Gammapathies (C1136085)
Definition (NCI) | A laboratory test result indicating the presence of an abnormally high level of monoclonal immunoglobulins in the blood or urine. |
Concepts | Neoplastic Process (T191) |
MSH | D010265 |
ICD10 | D47.2 , M9765/1 |
SnomedCT | 109983007, 123061006, 134180005, 190812003, 35601003 |
English | Gammapathy, Monoclonal, Monoclonal Gammopathies, [M] Monoclonal gammopathy, Gammopathies, Monoclonal, Gammapathies, Monoclonal, Monoclonal Gammapathy, Monoclonal Gammopathy, gammopathies monoclonal, monoclonal gammopathy, gammapathy monoclonal, monoclonal gammopathies, monoclonal gammapathies, monoclonal gammapathy, gammopathy monoclonal, [M] Monoclonal gammopathy (morphologic abnormality), Monoclonal gammopathies, Monoclonal gammopathy, Monoclonal gammopathy (clinical), Monoclonal gammopathy (disorder), gammopathy; monoclonal, monoclonal; gammopathy, Monoclonal gammopathy -RETIRED-, Monoclonal Gammapathies, Gammopathy, Monoclonal, Monoclonal gammopathy NOS |
Spanish | gammapatía monoclonal, Gammopatías Monoclonales, Gammopatía Monoclonal, gamopatía monoclonal (anomalía morfológica), gamopatía monoclonal, Gammapatía monoclonal, gammapatía monoclonal - RETIRADO - (concepto no activo), [M] gammapatía monoclonal, gammapatía monoclonal - RETIRADO -, [M] gammapatía monoclonal (anomalía morfológica), gammapatía monoclonal (clínica) (trastorno), gammapatía monoclonal (clínica), gammapatía monoclonal (trastorno), Gammapatía Monoclonal |
Portuguese | Gamopatia Monoclonal, Gamopatia monoclonal, Gamapatia Monoclonal, Gamopatias Monoclonais |
French | Gammapathie monoclonale, Gammopathie monoclonale, Gammapathies monoclonales |
German | Gammopathie, monoklonale, Monoklonale Gammopathie, monoklonale Gammopathie, Monoklonale Gammopathien |
Korean | 단클론성 감마병증 |
Dutch | monoclonale gammopathie, gammopathie; monoclonaal, monoclonaal; gammopathie, Monoclonale gammopathie, Monoklonale gammopathie, Gammopathie, monoklonaal |
Italian | Gammopatia monoclonale |
Japanese | タンクローンセイメンエキグロブリンケッショウ, 単クローン性免疫グロブリン血症, タンクローンセイメンエキグロブリンケツショウ |
Czech | Monoklonální gamapatie, monoklonální gamapatie, gamopatie monoklonální |
Hungarian | Monoclonalis gammopathia |
Norwegian | Monoklonal gammopati, Monoklonal gammopati med usikker signifikans, MGUS |