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We have a local "dispute" regarding the reporting of serum protein electrophoretic patterns in which a monoclonal gammopathy has appeared. Both "camps" believe that reporting a quantitation of the monoclonal band is appropriate. However, the difference lies in how the rest of the gamma globulin region should be reported. 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). The arguement for option 2 is that it provides a better indication of hypogammaglobulinemia or "nromal" gamma proteins. The counter arguement is that the monoclonal measurement includes a portion of the "normal" gamma globulin within it. Is there a guideline covering this? Michael McNeely MD FRCPC %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%