Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (1211 page)

   Monitoring patients with monoclonal gammopathies

   Diagnosis of monoclonal gammopathies, when used in conjunction with immunofixation

   Assist in the diagnosis of hepatic disease, hypogammaglobulinemias and hypergammaglobulinemias, inflammatory states, neoplasms, renal disease, and GI disorders

   SPE should also be considered in any patient with an elevated total serum protein or otherwise unexplained signs and symptoms suggestive of the presence of a plasma cell disorder. These include any one or more of the following:

   Elevated ESR or serum viscosity

   Unexplained anemia, back pain, weakness, or fatigue

   Osteopenia, osteolytic lesions, or spontaneous fractures

   Renal insufficiency with a bland urine sediment

   Heavy proteinuria in a patient older than 40 years of age

   Hypercalcemia

   Hypergammaglobulinemia

   Immunoglobulin deficiency

   BJ proteinuria