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Occurrence of Double Monoclonal Bands on Protein Electrophoresis: An Unusual Finding

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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.

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References

  1. 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

    Chapter  Google Scholar 

  2. Longsworth LG, Shedlovsky T, Macinnes DA (1939) Electrophoretic patterns of normal and pathological human blood serum and plasma. J Exp Med 70:399–413

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Moore DH, Kabat EA, Gutman AB (1943) Bence-jones proteinemia in multiple myeloma. J Clin Invest 22:67–75

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Riddell S, Traczyk Z, Paraskevas F et al (1986) The double gammopathies. Clinical and immunological studies. Medicine (Baltimore) 65:135–142

    Article  CAS  Google Scholar 

  6. 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

    Article  CAS  PubMed  Google Scholar 

  7. Kyle RA, Robinson RA, Katzmann JA (1981) The clinical aspects of biclonal gammopathies. Review of 57 cases. Am J Med 71:999–1008

    Article  CAS  PubMed  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. Kyle RA, Gertz MA, Witzig TE et al (2003) Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc 78:21–33

    Article  PubMed  Google Scholar 

  10. 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

    Article  PubMed  Google Scholar 

  11. 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

    Article  CAS  PubMed  Google Scholar 

  12. Kunkel HG (1968) The “abnormality” of myeloma proteins. Cancer Res 28:1351–1353

    CAS  PubMed  Google Scholar 

  13. Osterland CK, Chaplin H Jr (1966) Atypical antigenic properties of a gamma-A myeloma protein. J Immunol 96:842–848

    CAS  PubMed  Google Scholar 

  14. Sun T, Peng S, Narurkar L (1994) Modified immunoselection technique for definitive diagnosis of heavy-chain disease. Clin Chem 40:664

    CAS  PubMed  Google Scholar 

  15. 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

    CAS  PubMed  Google Scholar 

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Correspondence to Seema Chhabra.

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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.

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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

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