Knowledge Check

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What is the difference between monoclonal and polyclonal gammopathy?

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Immunoglobulins derived from multiple (polyclonal) or single (monoclonal) clone of plasma cells

True of false: polyclonal gammopathy is always associated with inflammation.

a

True

b

False

True or false: polyclonal gammopathy is associated with a sharp, narrow peak on SPEP.

a

True

b

False

True or false: the CRP in polyclonal gammopathy may be normal or high.

a

True

b

False

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Identify the bands labeled A-E

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A: Albumin
B: Alpha-globin-1
C: Alpha-globin-2
D: Beta-globin
E: Gamma globin

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Name 2 or 3 proteins in the alpha-1 (red) zone

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α1-antitrypsin (AT, 90%)
α 1-chymotrypsin
Thyroid-binding globulin

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Name 2 or 3 proteins in the alpha-2 (red) zone

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Haptoglobin
α2-macroglobulin
Ceruloplasmin

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Name 2 or 3 proteins in the beta (red) zone

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Transferrin
LDL
Complement proteins
IgA

What is the arrow pointing to:

a

A centrifuged blood sample

b

A mass spec result

c

A gel electrophoresis of plasma sample

d

A gel electrophoresis of serum sample

Correct. If it were plasma, it would show a large fibrinogen band!

Match the lettered SPEP with the correct diagnosis

C

A

B

Polyclonal gammopathy

Monoclonal gammopathy

Normal

Correct! Sorry, Incorrect.

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What can you say about the patient (red outline)

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Chronic inflammation:

Low albumin
Increased antitrypsin (alpha-1)
Increased haptoglobin (alpha-2)
Polyclonal gammopathy

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What is the treatment of choice for polyclonal gammopathy?

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Treat the underlying disease/condition

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