mGODS - Monoclonal Gammopathies Of Dermatological Significance

2021
Harvard Dermatology
Author

David M. Miller

Published

March 18, 2021

Pearls for working up monclonal gammopathies in setting of dermatological disease

TABLE OF CONTENTS

Overview & Learning Objectives
Pre-Lecture Questions 

Case 1
Additional Pre-Lecture Questions

Plasma Cell Dyscrasias
Detection and Identification of Monoclonal Proteins
References

Overview & Learning Objectives

Here, we provide a primer for that lecture. We start with a clinical case and some discrete questions so that you can think through them ahead of the lecture. We will go through these as a group on Thursday.

Pre-Lecture Questions

CASE 1

Synopsis

Case 1 Clinical Questions:

  • What does this part of the work up mean?
    • SPEP demonstrated abnormal band in gamma region
      • Identified by IFE as IgG Kappa
      • Represents by densitometry 10% (730 mg/dL) of total protein
  • What are you next steps in management?
  • While referral to hematology is never the wrong answer, if you wanted to pursue additional work up, what would be your next steps?

Additional Pre-Lecture Questions

  • True or False: An SPEP will both quantitate the M protein and identify the heavy and light chain associated with it?
  • True or False: A Bone Marrow Biopsy is recommended in all patients with an MGUS?
  • Myeloma is typically associated with: osteoblastic lesions or osteolytic lesions?
  • Which of the following is the most appropriate screening test(s) for the vast majority of plasma cell dyscrasias?
    • SPEP
    • SPEP + sFLC
    • SPEP + sIFE
    • SPEP + sFLC + sIFE
    • SPEP + sIFE + uPEP/IFE
    • SPEP, sFLC, sIFE, uPEP/IFE


Plasma Cell Dyscrasias

Overview

Plasma Cell Development

Monoclonal Gammapathies

Detection and Identification of Monoclonal Proteins

Overview

Take Home Points on Interrogating the Monoclonal Protein



References

This site represents our opinions only. See our full Disclaimer and Terms of Use Agreement

Footnotes

  1. Shalhout et al. Generalized Acquired Cutis Laxa Associated with Monoclonal Gammopathy of Dermatological Significance. Case Reports in Dermatological Medicine. 2020↩︎

  2. Katzmann JA. Screening panels for monoclonal gammopathies: time to change. Clin Biochem Rev. 2009;30(3):105-111.↩︎

  3. Waldenstrom J. Studies on conditions associated with disturbed gamma globulin formation (gammopathies). Harvey Lect. 1960;56:211-231.↩︎

  4. Kyle RA. Monoclonal gammopathy of undetermined significance. Natural history in 241 cases. Am J Med. 1978;64(5):814-826.↩︎

  5. Katzmann JA. Screening panels for monoclonal gammopathies: time to change. Clin Biochem Rev. 2009;30(3):105-111.↩︎