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What Does This Mean Monoclonal Bands Detected Are Faint?

Posted on Thu, 10 Oct 2024

Question: My mom has a hx of Bence XXXXXXX and I have been having polyclonal gammopathy and igm increase for as long as I can remember. I have just done the ife and se again and now it says immunofixation shows IgM monoclonal protein with lambda light chain specificity. Monoclonal bands detected are faint. What does this mean

Answered by Dr. Dr. Parth Goswami (12 hours later)

Brief Answer:
Monoclonal gammapathy & Neutropenia

Detailed Answer:
Hello,
Following is my opinion for your asked question.

The attached immunofixation electrophoresis shows monoclonal IgM.

So, Plasma cell dyscrasia could be present in your case. It include MGUS and multiple myeloma.

However, as written in reports, M bands are faint. So, you should repeat immunofixation electrophoresis after few weeks.

Meanwhile USG abdomen should be planned to check for any liver & spleen if palpable.

Your neutrophils also low which should be followed up with repeat CBC after few days.

Hope I have answered your question.

Let me know if you have more question in mind.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Parth Goswami (56 minutes later)

Does this always mean cancer?
Is it normal to have faint bands?
I have always had Polyclonal and is it common to change to monoclonal. What happens if the liver and spleen are palpable?

Answered by Dr. Dr. Parth Goswami (8 minutes later)

Brief Answer:
It could be Plasma cell dyscrasia. Detailed below.

Detailed Answer:
Hello,

Welcome Back.

Following is my further opinion for your asked question.

It is suggestive of plasma cell dyscrasia in which plasma cell in our body make excess immunoglobulin.

Now, This category range from MGUS, smoldering multiple myeloma to full development of multiple myeloma.

Multiple myeloma is form of blood cancer.

To rule out it, Bone marrow aspiration like higher investigation need to be done to calculate percentages of plasma cells. In multiple myeloma it could be more than 10% in marrow.

Your urine bence jone protein secretion and other molecular investigation can be planned.

Liver and spleen enlarged in case of blood cancers. So it should also be checked.

Faint band could be seen in case of low concentration of M protein.

So, you need to discuss all these with your treating doctor and discuss this approach for diagnosis of plasma cell dyscrasia.

Hope I have answered your question.

Let me know if I can assist you further.

Regards.

Above answer was peer-reviewed by : Dr. Saisudha Kotla

Follow up: Dr. Dr. Parth Goswami (11 hours later)

Thank you Dr, this is rather frightening. I will see hematologist next week. I have so many questions. Can the neutropenia be from something other than the obvious MGUS? Does the decrease in white count make anything more obvious or a give more of a clue as to a definitive answer on which one may be causing this or do they all have to be ruled out by urine, biopsy and ct scan?

Answered by Dr. Dr. Parth Goswami (1 hour later)

Brief Answer:
Follow up Question. Detailed Below.

Detailed Answer:
Hello,

Welcome back.

Following is my further opinion for your case.

Actually it is difficult to predict cause of neutropenia and low WBC cause without examination and further work up.

Sometime temporary infection also can suppress marrow and count could be low.In case of plasma cell dyscrasia as well it can get low.

However, in your case I suggest you visit hematologist & get work up for Plasma cell dyscrasia.

Flow cytometry, Bone marrow aspiration, urine or serum immunofixation electrophoresis etc. Some of the good investigation to rule out plasma cell dyscrasia.

So, discuss all these especially need for bone marrow with your treating doctor.

MGUS is form of precancerous plasma cell dyscrasia.

Hope I have answered your all query.

Let me know if you have more question in mind.

Best regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Parth Goswami (11 hours later)

I appreciate you taking the time to speak with me and go through everything as thoroughly as you can. Thank you

Answered by Dr. Dr. Parth Goswami (35 minutes later)

Brief Answer:
Follow up.

Detailed Answer:
Hello,

Welcome.

I will be happy to help you further whenever needed.

Take care.

Best Regards.

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Kampana