Kyle R A, Greipp P R
Mayo Clin Proc. 1978 Nov;53(11):719-39.
The monoclonal gammopathies are a group of disorders characterized by proliferation of a single clone of plasma cells that produce a homogeneous, monoclonal (M) protein. The structure of immunoglobulins, relationship of normal (polyclonal) immunoglobulins to myeloma and macroglobulin (monoclonal) immunoglobulins, pattern of monoclonal immunoglobulin overproduction, and laboratory methods for the recognition and study of monoclonal proteins in the serum and urine are reviewed. Interpretation of these laboratory tests is emphasized. The demonstration of a monoclonal protein in the serum or urine of a patient suggests multiple myeloma or one of its variants (solitary plasmacytoma of bone, extramedullary plasmacytoma, or plasma cell leukemia); Waldenström's macroglobulinemia or, occasionally, lymphoma; heavy-chain diseases (gamma, alpha, and mu); primary amyloidosis; and monoclonal gammopathies of undertermined significance. The electrophoretic and immunoelectrophoretic patterns found in the monoclonal gammopathies are discussed. Periodic electrophoresis of the serum and urine is essential in the follow-up and management of patients with a monoclonal gammopathy.
单克隆丙种球蛋白病是一组以产生均质单克隆（M）蛋白的单个浆细胞克隆增殖为特征的疾病。本文综述了免疫球蛋白的结构、正常（多克隆）免疫球蛋白与骨髓瘤及巨球蛋白（单克隆）免疫球蛋白的关系、单克隆免疫球蛋白过度产生的模式，以及血清和尿液中识别和研究单克隆蛋白的实验室方法。重点强调了这些实验室检测结果的解读。患者血清或尿液中出现单克隆蛋白提示可能患有多发性骨髓瘤或其变体之一（骨孤立性浆细胞瘤、髓外浆细胞瘤或浆细胞白血病）；华氏巨球蛋白血症，或偶尔提示淋巴瘤；重链病（γ、α和μ）；原发性淀粉样变性；以及意义未明的单克隆丙种球蛋白病。文中讨论了单克隆丙种球蛋白病中发现的电泳和免疫电泳模式。对于患有单克隆丙种球蛋白病的患者，定期进行血清和尿液电泳对于随访和治疗至关重要。
