ABSTRACT
Guidelines for clinical and laboratory evaluation of monoclonal gammopathies 285
Initial screen by serum protein electrophoresis and Penta immunofixation 290
k/l Total (not free) quantification and the diagnosis of monoclonal gammopathies 290
Following monoclonal gammopathies 296
Clues to detecting monoclonal gammopathies 296 Maintain an active file of all monoclonal
proteins 297 Screening and follow-up of MFLC 297 Monoclonals which may be difficult to diagnose 297 Final words 299 References 300
In the past decade there have been several changes to the testing available for the clinical evaluation of patients suspected of harboring a monoclonal gammopathy. As detailed in Chapters 2 and 3, improved resolution on gels and capillary zone electrophoresis, together with automated and semiautomated systems of electrophoresis and immunofixation, have provided more efficient and sensitive methods for these studies. Recent immunochemical methods to measure free light chains in serum and urine promise to enhance further our ability to detect and follow monoclonal proteins in these patients. Because of the sensitivity and efficiency of the new methodologies, our laboratory has changed our method of evaluating monoclonal gammopathies in the past few years. These methods allow for the efficient detection and immunochemical characterization of most monoclonal gammopathies in 1 day.
