Coagulation disorders in patients with monoclonal gammopathies

Monoclonal gammopathies can present as disorders of coagulation whether the gammopathy is due to a malignant B-cell lymphoproliferative disorder or a monoclonal gammopathy of undetermined significance. Detection of the monoclonal gammopathy involves quantification of immunoglobulins including kappa and lambda along with high-resolution electrophoresis of serum. Immunofixation is occasionally needed on serum and always needed on urine for the final diagnosis.