[An acute monoclonal gammopathy?].

Area of Science:

• Clinical Chemistry
• Nephrology
• Hematology

Background:

• Serum protein electrophoresis (SPEP) aids in diagnosing renal failure complications like monoclonal gammopathies.
• Monoclonal gammopathies can manifest as cast nephropathy, Randall's disease, or amyloidosis, often linked to renal failure.

Observation:

• A patient presented with two new monoclonal components on SPEP, absent just 10 days prior.
• The sudden appearance coincided with a urinary tract sepsis, suggesting a transient cause.

Findings:

• The monoclonal components gradually decreased after the sepsis resolved, confirming transient monoclonal gammopathy.
• Infectious or autoimmune diseases are primary triggers for transient monoclonal gammopathies.

Implications:

• Timing of SPEP is crucial; delaying post-acute episodes prevents misdiagnosis of hematologic malignancy.
• Recognizing transient gammopathies avoids unnecessary, costly investigations and invasive procedures like bone marrow biopsies.