Perché è importante identificare e segnalare le piccole componenti monoclonali

AUTORI

ABSTRACT

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.

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