Paraproteinemia

Paraproteinemia is said to be present when large amount of paraprotein is found in the blood. It is also referred to as monoclonal gammopathy, so when the presence of monoclonal gammaglobulin is more than required in the blood, it is termed as monoclonal gammopathy. A paraprotein is produced in excess by the clonal proliferation of plasma cells. It is an abnormal immunoglobulin or a part of an Ig reaction (light chain). These plasma cells are produced by a type of B cell. Thus, if these monoclonal gammaglobulins are found in big or excessive quantities in blood, it denotes a deviation in the duplication of plasma cells.

Causes

Immunoproliferative disorders such as lymphomas, leukemia and plasma cell dyscrasia or cancers usually give reason to paraproteinemia. Other causes may include myeloma, plasmacytoma lymphoplasmacytic lymphoma. Another rather unknown cause, monoclonal gammopathy of undermined significance, may lead to the appearance of this disease. When a single monoclonal gammaglobulin increases highly in amounts, paraproteinemia occurs. Paraproteins have the ability of cloning itself. A single parent cell can replicate itself for multiple numbers of times. These monoclonal cells carry very similar characteristics of that of a cancer cell.

Types of Paraproteinemia

Paraproteinemia

Depending upon the type of paraprotein found in the blood, paraproteins are divided in to three different types. The first type is the light chain type. This is a small polypeptide subunit of an immunoglobulin. This is also known as “the Light chained disease”. Just like in other mammals, even in humans, there are two types of light chains. One is the kappa chain and the other is the lambda chain. Both of these are found on different chromosomes.

The second type of paraproteinemia is classified by the abundance of only heavy chains. In a protein the large polypeptide subunit is referred to as heavy chain. This is also known as “heavy chain disease”. The common features of this disease include, anemia, a general feeling of sickness through the body (body malaise), enlargement of the spleen, the liver and the lymph nodes, fever and an overall weakness.

The third type of paraproteinemia is referred to as whole immunoglobulins. In this type, both the light chain and heavy chain immunoglobulins are often involved in an abnormal ratio.

The three of paraproteins mentioned above may exist independently or in combination in a given individual. Bence Jones proteins are also later formed. These are light chain imunoglobulins that escape the blood and are excreted in the urine by the kidneys. However, the heavy chain and whole immunoglobulins continue to stay within the blood.

Type of people in whom paraprotein is found

Amongst the general population, the following people have a higher tendency of having paraproteinemia. The elderly have a higher chance of developing it as compared to the younger ones. The African Americans have a higher chance as compared to the Caucasian populace. People above 50 years of age have a 3.2% chance whereas people above 70 years of age have a 5.3% chance. This disease is not always associated with malignancy.

Problems

Having excess paraproteins can cause number of problems. Some of these problems have been mentioned here. It can cause neuropathy, nephropathy, cytopenias (two types, ITP or AIHA), cold agglutinins and cryoglobulins. Nephropathy is caused especially due to light chains.

Common symptoms

If you have the following symptoms, you may want to get tested for excessive paraproteins:

  • Impaired renal function
  • Hypercalcaemia
  • Recurrent bacterial infections
  • Hyperviscosity
  • Malaise and fatigue
  • Bone disease

These are some of the symptoms for which you may avail diagnosis.

Diagnosis of Paraprotenimia

There are various ways to diagnose this condition. One of the ways includes the serum protein electrophoresis. This is a protein electrophoresis which comprises of the separation of the proteins present in blood on the basis of their electrical charge. In this diagnosis, a narrow spike or band will appear if paraproteins are found in the blood.

Other ways include or may require Serum immunofixation electrophoresis, Serum free light chain and quantitative immunoglobulins.

Further Advice

Paraproteinemia must not be taken lightly. It can have serious effects on the human body. It is highly advisable to consult a doctor on appearance of any symptoms. Doctors will then provide you with appropriate treatment. It is always better to have the respective treatment commenced at an earlier point.

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