Monoclonal Gammopathy: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Amyloidosis – extracellular (“outside the cell”) deposition of amyloids (degradation-resistant proteins); possible symptoms: purpura (capillary hemorrhage), cardiomyopathy (heart muscle disease), macroglossia (enlargement of the tongue, carpal tunnel syndrome (KTS), peripheral neuropathy (disease of the peripheral nervous system), nephrotic syndrome

Musculoskeletal system and connective tissue (M00-M99).

  • Osteoporosis (bone loss)
  • Rheumatism or rheumatic diseases

Neoplasms – tumor diseases (C00-D48)

  • Chronic lymphocytic leukemia (CLL); possible symptoms: Fatigue, tiredness, fever, night sweats (night sweats), high susceptibility to infection, hemorrhagic diathesis (bleeding tendency), pale skin color, dyspnea (shortness of breath).
  • Franklin syndrome (synonym: gravity chain disease); possible symptoms: resembles lymphoma rather than plasmacytoma; lymph node, spleen and liver swelling, fever episodes, increased susceptibility to infection.
  • Hodgkin’s lymphoma; possible symptom: enlarged, indolent (painless) lymph node, often occurring in the neck region or axilla (armpit) (age groups 20 to 40 years and over 50 years)
  • Lymphoma
  • Waldenström’s disease (synonym: Waldenström’s macroglobulinemia) – malignant lymphoma disease; classified as B-cell non-Hodgkin’s lymphoma; typically abnormal production of monoclonal immunoglobulin M (IgM) by the lymphoma cells (= monoclonal gammopathy type IgM); Form of paraproteinemia in which osteoporosis and episodic purpura (capillary hemorrhage) occur; unlike plasmocytoma, neither osteolysis (bone loss) nor hypercalcemia (calcium excess) are observed. Possible symptoms: Fatigue, headache, visual disturbances, bleeding.
  • Marginal zone B-cell lymphoma (MZL) (very rare).
  • Monoclonal gammopathy of uncertain significance (MGUS) – precancerous condition for lymphoproliferative disorders such as multiple myeloma or Waldenström’s disease; paraproteinemia with monoclonal IgM globulins without histologic infiltration of the bone marrow with plasma cells or lymphoma cells (i.e., no plasmacytoma/multiple myeloma or Waldenström’s disease); in the United States, monoclonal gammopathy of unclear significance (MGUS) is found in 3.2% of those over 50 years of age and 5.3% of those over 70 years of age; progresses to lymphoproliferative disease in 1.5% of cases per yearNote: MGUS may persist for more than 30 years before clinical disease develops; in these patients, an additional jag, the “M gradient,” can be seen in the gamma globulin region. This indicates the spread of cell clones in the bone marrow.
  • Non-Hodgkin’s lymphoma; possible symptoms: Night sweats, pruritus (itching), fever , weight loss and listlessness (rarely before the age of 40).
  • Nonsecretory myeloma – plasma cell neoplasia (neoplasm).
  • Plasmocytoma (synonyms: Bence Jones plasmocytoma; Hupert’s disease; Kahler-Buzzolo disease; malignant plasmoma; Kahler’s disease; multiple plasma cell tumor; multiple myeloma; multiple plasma cell myeloma; myeloma; Myelomatosis; plasma cell myeloma; reticulosis plasmacellularis; medullary plasmacytoma) – malignant (malignant) systemic disease belonging to the non-Hodgkin’s lymphomas of B lymphocytes.
  • Smouldering (asymptomatic) myeloma.
  • Solitary plasmacytoma of the bone

Psyche – nervous system (F00-F99; G00-G99)

  • Cephalgia (headache)

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

  • Kidney disease, unspecified

Injuries, poisonings, and other consequences of external causes (S00-T98)

  • Fractures of all kinds