BMJ  2006;333:185-187 (22 July), doi:10.1136/bmj.333.7560.185

Practice

Cases in primary care laboratory medicine

Paraprotein management

¹ Clinical Laboratory, General Hospital, Bishop Auckland DL14 6AD, ² Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP

This article explores best practice in the investigation and monitoring of paraprotein bands in blood or urine. It looks at the pitfalls and provides a summary of guidance

The first 150 words of the full text of this article appear below.

We present two cases illustrating the use of electrophoresis in the diagnosis and monitoring of plasma cell dyscrasias. The presence of monoclonal protein bands (paraproteins) in myeloma is well recognised; other conditions in which paraproteins may be seen are less well understood, as is the relatively common monoclonal gammopathy of unknown significance (MGUS) often previously referred to as benign paraproteinaemia.

A 58 year old woman was referred urgently to hospital with a three month history of lethargy, weight loss, dysphagia, and nausea. On the day she was seen by her general practitioner she was weak and hypotensive (90/58 mm Hg). Examination showed an underweight woman (body mass index 19) with a blood pressure of 90/60 mm Hg, pulse 90 beats per minute, muscle wasting, no oedema, and no focal neurological signs.

Results of initial laboratory investigations were sodium 128 mmol/l, potassium 5.2 mmol/l, urea 7.2 mmol/l, creatinine 105 µmol/l, total . . . [Full text of this article]

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This article has been cited by other articles:

• Kariyawasan, C.C., Hughes, D.A., Jayatillake, M.M., Mehta, A.B. (2007). Multiple myeloma: causes and consequences of delay in diagnosis. QJM 100: 635-640 [Abstract] [Full text]  

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Paraprotein management

Arthur R Bradwell, et al.
bmj.com, 7 Aug 2006 [Full text]

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Paraprotein Management

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