Clinical and biochemical analysis of patients with monoclonal gammopathy -2 years' experience of Akdeniz University Faculty of Medicine -

In this study, we aimed to demonstrate different indications to order immunofixation electrophoresis (IFE) from different inpatient and outpatient clinics, correlations between IFE results and patients' clinical and laboratory characteristics and classify confirmed cases of monoclonal gammopathy (MG). Four thousand six hundred and two IFE tests conducted between December 2013 and July 2016 were included in this study. Five hundred cases with MG were retrospectively evaluated. Age, gender, serum and urine IFE results, clinical data, indication to order test and final diagnosis were accessed from medical files retrospectively. Out of 472 patients with MG, median age was 64 years (range 17-90), 52.5% were male and 47.5% were female. 74% of IFEs were ordered by Hematology, 13.1% were ordered by General Internal Medicine department, 5% were ordered by other internal medicine departments; remainder were ordered by different clinics. %59,5 of IFEs were ordered as diagnostic workup for multiple myeloma, 13,3% were ordered to diagnose possible lymphoma; 2.5% for diagnostic workup of polyneuropathy and 0.4% were ordered for diagnostic workup of amyloidosis. Indication to order IFE was unaccessable for 114 patients. Within the patients with definitive diagnosis and MG, 44.5% patients had plasma cell diseases, and 14.6% had lymphoprofilerative diseases. Most common non-hematological condition associated with MG were rheumatological diseases. Patients with MG were most commonly positive for IgG-Kappa MG (35,3%) and IgG-Lambda MG (10,8%) in serum IFE. Most common MG in urine IFE were kappa light chain MG (5,6%), and lambda light chain MG (2.4%). In conclusion, IFE were most commonly ordered by Hematology and other branches of Internal Medicine. Most common indication to order IFE was to diagnose and follow up plasma cell and lymphoproliferative diseases. However, clinicians should also be aware of other indications to order IFE in diagnostic workup of rare diseases with different clinical presentations such as unexplained polyneuropathies or autoimmune diseases which may be associated with MG. Awareness of clinicians within other disciplines should be increased regarding the usefulness of IFE and rare clinical presentation of MG.