Paraproteinaemia

Key Information

Appropriate Tests

 

Full blood count, Blood film, Protein (total) and Protein electrophoresis with paraprotein quantitation and typing, Immunoglobulins G, A, M , Beta-2-microglobulin, Free light chains.

Protein urine, Bence Jones protein urine.

Bone marrow aspiration and trephine biopsy is usually not required in elderly, asymptomatic patients with small paraproteins (<10 g/L), no bone lesions, or evidence of bone marrow or other organ failure.

See Table 2.

Causes

 

Waldenström's macroglobulinaemia

 

Lymphoma (non-Hodgkin)

 

Heavy chain disease

 

Primary Amyloidosis

 

Monoclonal gammopathy of undetermined significance (MGUS)

 

Smouldering plasma cell myeloma

See Plasma cell myeloma