ABSTRACT
Differentiation of B lymphocytes 145 Conditions associated with monoclonal
gammopathies 148 Multile myeloma 151 Heavy chain disease 168 Waldenström’s macroglobulinemia 171 Monoclonal gammopathy associated with tissue
deposition: amyloidosis and non-amyloid monoclonal immunoglobulin deposition disease 176
Solitary plasmacytoma 179 Monoclonal gammopathies not associated with
B-lymphoproliferative disorders 179
POEMS syndrome 180 Monoclonal gammopathy of undetermined
significance 181 Monoclonal gammopathies in infectious
diseases 183 Monoclonal gammopathies in
immunodeficiency 184 Cryoglobulins 185 Bands mistaken for monoclonal
gammopathies 190 Unusual effects of monoclonal gammopathies
on laboratory tests 192 References 193
A monoclonal gammopathy is defined as the electrophoretically and antigenically homogeneous protein product of a single clone of B lymphocytes and/or plasma cells that has proliferated beyond the constraints of normal control mechanisms. Monoclonal gammopathies are detected in serum and/or urine from individuals with a wide variety of neoplastic, potentially neoplastic, neurological and infectious conditions. The monoclonal gammopathy is produced by a single clone of plasma cells or B lymphocytes. Several terms have been used to refer to monoclonal gammopathies: paraprotein, dysproteinemia, monoclonal gammopathy, monoclonal component, and M-protein.1,2
The guidelines for clinical and laboratory evaluation of patients with monoclonal gammopathies
has recommended the use of the term ‘M-protein’ and I will use it in this chapter interchangeably with monoclonal gammopathy.3
