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Previous Volume 355:2765-2770 December 28, 2006 Number 26 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A 58-year-old man with no significant medical history is found to have an elevated total protein concentration (8.1 g per deciliter) on a routine blood chemical study. He is asymptomatic, and his physical examination is normal. Serum protein electrophoresis reveals a monoclonal spike of 2.1 g per deciliter at the gamma region; immunofixation shows a monoclonal IgG kappa protein. What further evaluation . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Evaluation

Laboratory Testing

Predictors of Progression to Multiple Myeloma or Other Related Malignant Disorders

Management

Areas of Uncertainty

Guidelines

Summary and Recommendations

Source Information

From the Hematology Department, Institut Clinic de Malaties Hematologiques i Oncologiques (ICMHO), Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Postgraduate School of Hematology Farreras Valentí, Universitat de Barcelona, Barcelona.

Address reprint requests to Dr. Bladé at the Hematology Department, Universitat de Barcelona Hospital Clínic, Villarroel 170, E-08036 Barcelona, Spain, or at jblade@clinic.ub.es.

Related Letters:

Monoclonal Gammopathy of Undetermined Significance
Minisola S., Pepe J., Romagnoli E., Bladé J.
Extract | Full Text | PDF  
N Engl J Med 2007; 356:2223-2224, May 24, 2007. Correspondence

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