Abstract
Various techniques of protein electrophoresis are used for detection of monoclonal proteins/paraproteins in serum and/or urine of patients with monoclonal gammopathies. These are detected as the so-called ‘M’ bands (monoclonal bands) on serum protein electrophoresis and/or immunofixation electrophoresis. In most cases, a single M-band is detected. However, more than one M-band can be detected in the samples of a minor proportion of patients. This condition is termed as ‘double gammopathy’ or ‘biclonal gammopathy’. A knowledge of such an unusual occurrence is essential for recognition and appropriate interpretation of this entity.
References
Katzmann J, Kyle RA, Lust J et al (2013) Immunoglobulins and laboratory recognition of monoclonal proteins. In: Wiernik PH, Goldman JM, Dutcher JP et al (eds) Neoplastic diseases of blood, 5th edn. Springer, New York, pp 565–588
Longsworth LG, Shedlovsky T, Macinnes DA (1939) Electrophoretic patterns of normal and pathological human blood serum and plasma. J Exp Med 70:399–413
Moore DH, Kabat EA, Gutman AB (1943) Bence-jones proteinemia in multiple myeloma. J Clin Invest 22:67–75
Tschumper RC, Dispenzieri A, Abraham RS et al (2013) Molecular analysis of immunoglobulin genes reveals frequent clonal relatedness in double monoclonal gammopathies. Blood Cancer J 3:e112
Riddell S, Traczyk Z, Paraskevas F et al (1986) The double gammopathies. Clinical and immunological studies. Medicine (Baltimore) 65:135–142
Bakkus MH, Schots R, Gomez La Fuente PB et al (2000) Clonally related IgA- and IgE-secreting plasma cells in a myeloma patient. Eur J Haematol 65:348–355
Kyle RA, Robinson RA, Katzmann JA (1981) The clinical aspects of biclonal gammopathies. Review of 57 cases. Am J Med 71:999–1008
Kyle RA, Therneau TM, Rajkumar SV et al (2002) A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N Engl J Med 346:564–569
Kyle RA, Gertz MA, Witzig TE et al (2003) Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc 78:21–33
Guastafierro S, Ferrara MG, Sica A et al (2012) Serum double monoclonal components and hematological malignancies: only a casual association? Review of 34 cases. Leuk Res 36:1274–1277
Garcia-Garcia P, Enciso-Alvarez K, Diaz-Espada F et al (2015) Biclonal gammopathies: retrospective study of 47 patients. Rev Clin Esp 215:18–24
Kunkel HG (1968) The “abnormality” of myeloma proteins. Cancer Res 28:1351–1353
Osterland CK, Chaplin H Jr (1966) Atypical antigenic properties of a gamma-A myeloma protein. J Immunol 96:842–848
Sun T, Peng S, Narurkar L (1994) Modified immunoselection technique for definitive diagnosis of heavy-chain disease. Clin Chem 40:664
Bradwell AR, Carr-Smith HD, Mead GP et al (2001) Highly sensitive, automated immunoassay for immunoglobulin free light chains in serum and urine. Clin Chem 47:673–680
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Rights and permissions
About this article
Cite this article
Srinivasan, V.K., Bhagat, P., Bansal, F. et al. Occurrence of Double Monoclonal Bands on Protein Electrophoresis: An Unusual Finding. Indian J Hematol Blood Transfus 32 (Suppl 1), 184–188 (2016). https://doi.org/10.1007/s12288-015-0622-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12288-015-0622-2