Definition
Paraprotein detected on immunoglobulin analysis – usually given immunoglobulin subtype (e.g. IgG Kappa). May be only serum light chains (e.g. Lambda light chains).
REFER ALL PATIENTS with a paraprotein. Please also note that IgM paraproteins more often occur in the setting of lymphoma rather than myeloma.
C.M & L.W 26-06-23
Who to refer:
- Refer all patients with a paraprotein. (In general, patients will be assessed in clinic; however, in some cases, advice on further investigation and/or management may be provided by correspondence)
- URGENT referral for patients with possible myeloma – renal impairment, hypercalcaemia, hyperuricaemia, pathological fracture, bone pain, spinal cord compression
Who not to refer:
- Polyclonal increase in immunoglobulins. This is most likely caused by chronic inflammatory or infective processes.
How to refer:
SCI Gateway – to Department of Haematology WGH or St Johns.
Primary care investigations
- FBC
- Biochemistry including renal function, liver function, calcium, albumin, urate
- Urine for Bence-Jones proteins
