Monoclonal gammapathies

The presence of a serum and/or urinary monoclonal immunoglobulin (monoclonal component, MC), or its subunits, heavy and light chains produced by a B cell clone in serum and/or urine characterizes a wide group of conditions called monoclonal gammapathies (MG). In most instances, the MG is clinically silent, and remains so throughout life. However, the clone may be, or will become, clinically overt because of its proliferation (i.e., multiple myeloma and its variants) and/or because the MC produces organ damage (i.e., kidney failure, amyloidotic cardiomyopathy, etc.). The clinical laboratorian greatly contributes to the diagnosis and management of these conditions mainly through detection and quantitation of the monoclonal immunoglobulin, which represents an ideal tumor marker.