OPINIONI - Opinions
Biochimica Clinica 2012; 36(1) 25-28
Perché è importante identificare e segnalare le piccole componenti monoclonali
Laboratori di Biotecnologie, Laboratorio di Analisi Chimico-Cliniche, Fondazione IRCCS Policlinico San Matteo, Dipartimento di Medicina Molecolare, Università di Pavia
Small monoclonal immunoglobulins should not be neglected
The detection of a monoclonal immunoglobulin in serum or urine usually raises concerns about the size of the underlying B-cell-derived clone and possible systemic effects caused by its expansion. However, a small clone can synthesize a very toxic protein, producing systemic damage and protean clinical presentations.The monoclonal protein can aggregate and deposit systemically as occurs in light-chain amyloidosis, monoclonal immunoglobulin deposition disease, and monoclonal cryoglobulinemia.The clone synthesizing noxious monoclonal proteins is often small and sensitive techniques may be required to detect these immunoglobulins. A delay in diagnosis can cause irreversible organ damage and dramatically shorten survival. Prompt recognition of suggestive signs and symptoms should trigger a thorough diagnostic approach to reach the correct diagnosis quickly, as this is the key to effective therapy.