Myeloma protein

In 1940, senior pathologist Kurt Apitz of the Charité – Berlin University Medicine hospital, introduced the concept and word paraprotein.

[2] and Concise Review[3] Detection of paraproteins in the urine or blood is most often associated with MGUS, where they remain "silent",[4] and multiple myeloma.

Blood serum paraprotein levels of more than 30 g/L is diagnostic of smouldering myeloma, an intermediate in a spectrum of step-wise progressive diseases termed plasma cell dyscrasias.

Elevated paraprotein level (above 30 g/L) in conjunction with end organ damage (elevated calcium, kidney failure, anemia, or bone lesions) or other biomarkers of malignancy, is diagnostic of multiple myeloma, according to the diagnostic criteria of the International Myeloma Working Group,[5] which were updated in 2014.

[6] Detection of paraprotein in serum of less than 30 g/L is classified as monoclonal gammopathy of undetermined significance in cases where clonal plasma cells constitute less than 10% on bone marrow biopsy and there is no myeloma-related organ or tissue impairment.

Serum protein electrophoresis showing a paraprotein (spike/peak in the gamma zone) in a patient with multiple myeloma .