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Paraproteinemia

Paraproteinemia
Classification and external resources
ICD-10 D89.2
ICD-9-CM 273.1 - 273.2
DiseasesDB 9614
MeSH D010265

Paraproteinemia, or monoclonal gammopathy, is the presence of excessive amounts of paraprotein or single monoclonal gammaglobulin in the blood. It is usually due to an underlying immunoproliferative disorder.

It is sometimes considered equivalent to plasma cell dyscrasia.[1]

Contents

  • Types 1
  • Possible causes 2
  • Diagnosis 3
  • See also 4
  • References 5
  • External links 6

Types

Paraproteinemias may be categorized according to the type of monoclonal protein found in blood:

The three types of paraproteins may occur alone or in combination in a given individual. Note that while most heavy chains or whole immunoglobulins remain within blood vessels, light chains frequently escape and are excreted by the kidneys into urine, where they take the name of Bence Jones protein.

It is also possible for paraproteins (usually whole immunoglobulins) to form polymers by aggregating with each other; this takes the name of macroglobulinemia and may lead to further complications. For example, certain macroglobulins tend to precipitate within blood vessel with cold, a phenomenon known as cryoglobulinemia. Others may make blood too viscous to flow smoothly (usually with IgM macroglobulins), a phenomenon known as Waldenström macroglobulinemia.

Possible causes

Diagnosis

These disorders are characterized by the presence of any abnormal protein that is involved in the immune system, which are most often immunoglobulins and are associated with the clonal proliferation of lymphocytes.[2]

When a paraproteinemia is present in the blood, there will be a narrow band, or spike, in the serum protein electrophoresis because there will be an excess of production of one protein.[3]

There are two large classes of blood proteins: albumin and globulin. They are generally equal in proportion, but albumin is much smaller than globulin, and slightly negatively charged, which leads to an accumulation at the end of the electrophoretic gel. The globulins separate out into three regions on the electrophoretic gel, which are the α band, the β band, and the γ band.

  • The γ band is where the immunoglobulins appear, which is why they are also known as gammaglobulins.[5] The majority of paraproteins appear in this band.[4]

See also

References

  1. ^ "paraproteinemia" at Dorland's Medical Dictionary
  2. ^ Health Communication Network. Immunoproliferative disorders- Topic Tree. http://www.use.hcn.com.au/subject.%60Immunoproliferative%20Disorders%60/home.html Accessed March 2007.
  3. ^
  4. ^ a b
  5. ^ Abbas, A.K and Lichtman, A.H. Cellular and Molecular Immunology. Fifth Edition. Elsevier Saunders. Philadelphia. 2005

External links

  • Paraproteinaemia at patient.info.
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