paraproteinaemias

Paraproteinaemias refer to conditions characterized by the presence of abnormal proteins, known as paraproteins or monoclonal proteins, in the blood or urine. These paraproteins are typically immunoglobulins, which are antibodies produced by a specific clone of B cells. While some paraproteinaemias are benign, others can be associated with a range of hematological disorders, including multiple myeloma, Waldenström macroglobulinemia, and amyloidosis.

The production of a paraprotein indicates an underlying abnormality in B cell proliferation. In benign monoclonal gammopathy (BMG), the paraprotein is produced in small amounts and does not cause symptoms or organ damage. BMG is more common in older individuals and may be a precursor to more serious conditions. In contrast, malignant paraproteinaemias involve the uncontrolled growth of malignant plasma cells or lymphocytes, leading to the overproduction of a specific immunoglobulin.

Symptoms associated with paraproteinaemias can vary depending on the underlying cause and the amount of paraprotein produced. They may include fatigue, bone pain, increased risk of infection, kidney problems, and neurological symptoms. Diagnosis typically involves blood and urine tests to detect and quantify the paraprotein, as well as bone marrow biopsy to assess for underlying malignancy. Treatment strategies are tailored to the specific condition and may range from observation for benign cases to chemotherapy or other targeted therapies for malignant forms.