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Paraproteinaemias

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Paraproteins are immunoglobulins of a single, unique structure i.e. produced by a single clone, which are present in sufficient amounts to be seen on serum electrophoresis. A sharp band is seen because all of the molecules have an identical structure. Examples include:

Benign:

  • monoclonal gammopathy of undetermined significance

Malignant:

  • Myeloma
  • Waldenstrom's macroglobulinaemia
  • Heavy chain disease

Other causes of paraproteinaemias include:

  • paroxysmal cold haemoglobinuria - Donath-Landsteiner antibody
  • cold haemagluttin disease - IgM paraprotein
  • warm antibody haemolytic anaemia
  • chronic lymphatic leukaemia - IgG or IgM paraprotein

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