In article <[log in to unmask]>, McNeely, Michael
<[log in to unmask]> writes
>
>1. One camp feels that the "gamma globulin" should be all the gamma globulin
>(the sum of the monoclonal plus all the "normal" gamma globulin).
>2. The other camp wishes to report the monoclonal and then "all the rest" of the
>gamma globulin as a separate amount (total gamma minus the monoclonal).
>
>
>Is there a guideline covering this?
>
I don't know of any guidelines but locally we report:
1 Total IgG, IgA, IgM, total protein, albumin, total globulins.
2 Monoclonal gammopathy concentration estimate by scan densitometry
3 Qualitative description of appearance of paraprotein -
- position (for example: at the origin)
- strength (for example: very weak)
- other (for example: densitometry unsatisfactory because
of background beta globulin proteins)
4 Qualitative (subjective) description of appearance of non-paraprotein
gamma globulins - either
"normal gamma globulins appear suppressed"
or
"normal gamma globulins do not appear suppressed"
If normal gamma globulins appear suppressed this is very
significant clinically, because the patient has a poor prognosis
without treatment.
Robin Marks
Halifax
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