Continuing Medical Education
Laboratory testing in the evaluation of a monoclonal protein: A practical framework for interpretation
Abstract
Monoclonal proteins are immunoglobulins secreted by identical but abnormal plasma cells that are clones of a parent cell. While routine screening in the absence of signs or symptoms of disease is not recommended, testing is indicated in the diagnostic work-up for multiple myeloma and other plasma cell disorders. When indicated, a serum protein electrophoresis with immunofixation and serum free light-chain assay should be performed to determine the type and quantity of monoclonal protein. Using a case-based approach, we highlight common misconceptions with monoclonal protein investigations, and suggest a practical framework for diagnostic interpretation.
Authors' affiliations
B L Houston, Section of Hematology and Medical Oncology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; and Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Canada
E Rimmer, Section of Hematology and Medical Oncology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; and Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Canada
R Zarychanski, Section of Hematology and Medical Oncology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; and Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Canada
M Seftel, Section of Hematology and Medical Oncology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; and Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Canada
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Date published: 2019-09-30
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