Differential diagnosis
This includes:
- benign monoclonal gammopathy:
- there is no skeletal disease, no hypogammaglobinaemia, and no Bence Jones protein
- observe if in doubt since there is no advantage to early treatment of asymptomatic multiple myeloma
- smouldering (asymptomatic) multiple myeloma
- symptomatic multiple myeloma
- plasmacytoma (1)
- reactive polyclonal hypergammaglobulinaemia - distinguished on basis of single or polyclonal spike
- other malignant lymphoproliferative diseases:
- Waldenstrom's macroglobulinaemia
- lymphomas
- primary amyloidosis
- osteosclerotic myeloma
Reference:
- Sive, J., Cuthill, K., Hunter, H., Kazmi, M., Pratt, G., Smith, D. and (2021), Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline. Br. J. Haematol., 193: 245-268.
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