{"id":4285,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paraprotein\/"},"modified":"2023-08-31T14:25:13","modified_gmt":"2023-08-31T13:25:13","slug":"paraprotein","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/haematology\/paraprotein\/","title":{"rendered":"Paraprotein"},"content":{"rendered":"\n<title>Paraprotein<\/title>\n\n\n\n<h4 class=\"wp-block-heading\">Definition&nbsp; <\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Paraprotein detected on immunoglobulin analysis \u2013 usually given immunoglobulin subtype (e.g. IgG Kappa).\u00a0 May be only serum light chains (e.g. Lambda light chains).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">REFER ALL PATIENTS with a paraprotein. Please also note that IgM paraproteins more often occur in the setting of lymphoma rather than myeloma.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.M &amp; L.W 26-06-23<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Refer all patients with a paraprotein.&nbsp;&nbsp;(In general, patients will be assessed in clinic; however, in some cases, advice on further investigation and\/or management may be provided by correspondence)<\/li>\n\n\n\n<li>URGENT referral for patients with possible myeloma \u2013 renal impairment, hypercalcaemia, hyperuricaemia, pathological fracture, bone pain, spinal cord compression<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Polyclonal increase in immunoglobulins.&nbsp;&nbsp;This is most likely caused by chronic inflammatory or infective processes.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">SCI Gateway &#8211; to Department of Haematology WGH or St Johns.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Primary care investigations<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>FBC<\/li>\n\n\n\n<li>Biochemistry including renal function, liver function, calcium, albumin, urate<\/li>\n\n\n\n<li>Urine for Bence-Jones proteins<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\"><\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Paraprotein Definition&nbsp; Paraprotein detected on immunoglobulin analysis &ndash; usually given immunoglobulin subtype (e.g. IgG Kappa).&nbsp; 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 &amp; L.W 26-06-23<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3981,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[270],"class_list":["post-4285","page","type-page","status-publish","hentry","category-paraprotein"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/haematology\/paraprotein\/\" rel=\"tag\">Paraprotein<\/a>","rttpg_excerpt":"Paraprotein Definition&nbsp; Paraprotein detected on immunoglobulin analysis &ndash; usually given immunoglobulin subtype (e.g. IgG Kappa).&nbsp; 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 &amp; L.W 26-06-23","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4285","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4285"}],"version-history":[{"count":7,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4285\/revisions"}],"predecessor-version":[{"id":16137,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4285\/revisions\/16137"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3981"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4285"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4285"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}