M-protein level is usually greater than 3 g per dL. M protein appears as a narrow spike in the gamma, beta, or alpha 2 regions. Pulmonary disorders, including bronchiectasis, cystic fibrosis, chronic bronchitis, and pneumonitisĮndocrine diseases, including Graves’ disease and hashimoto’s thyroiditis Gastrointestinal conditions, including ulcerative colitis and Crohn’s disease Hematologic and lymphoproliferative disorders Viral infections, especially hepatitis, human immunodeficiency virus infection, mononucleosis, and varicellaįocal or systemic bacterial infections, including endocarditis, osteomyelitis, and bacteremia Rheumatoid and collagen diseases (connective tissue disorders) Impaired liver function resulting from decreased synthesis of albuminĬhronic infections (granulomatous diseases) Hemorrhage, burns, or protein-losing enteropathies In contrast, polyclonal gammopathies may be caused by any reactive or inflammatory process. The quantity of M protein, the results of bone marrow biopsy, and other characteristics can help differentiate multiple myeloma from the other causes of monoclonal gammopathy. Monoclonal gammopathies are associated with a clonal process that is malignant or potentially malignant, including multiple myeloma, Waldenström’s macroglobulinemia, solitary plasmacytoma, smoldering multiple myeloma, monoclonal gammopathy of undetermined significance, plasma cell leukemia, heavy chain disease, and amyloidosis. A homogeneous spike-like peak in a focal region of the gamma-globulin zone indicates a monoclonal gammopathy. Plasma protein levels display reasonably predictable changes in response to acute inflammation, malignancy, trauma, necrosis, infarction, burns, and chemical injury. Electrophoresis separates proteins based on their physical properties, and the subsets of these proteins are used in interpreting the results. Serum protein electrophoresis is used to identify patients with multiple myeloma and other serum protein disorders.
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