WebThe Leukemia & Lymphoma Society (LLS) is a global leader in the fight against blood cancer. A blood screening and sometimes a urine screening is recommended. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. This has to be examined carefully. Bence-Jones proteins are 1 type. 2006;81(12):1575-1578, 4. This test separates proteins based on their size and other factors. Normal value ranges may vary slightly among different laboratories. Mayo Clinic does not endorse companies or products. for Monoclonal gammopathy of undetermined significance (MGUS), Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Monoclonal gammopathy of undetermined significance (MGUS). An absent alpha-1 fraction is consistent with A1AT deficiency disease and should be followed by a quantitative A1AT assay (AAT / Alpha-1-Antitrypsin, Serum). A 24-hour urine collection can help determine if abnormal protein is being released into your urine. High blood protein rarely causes signs or symptoms on its own. Monoclonal proteins are markers of plasma cell proliferative disorders. Make a donation. MGUS is usually detected by chance when you have a blood test for another condition. When M proteins begin to outnumber normal blood cells, this can result in a low blood count and health complications, such as: Health experts arent sure exactly what causes multiple myeloma. Electrophoretic studies revealed that one or more fractions were outside the reference interval. Monoclonal gammopathy of undetermined significance (MGUS) care at Mayo Clinic. This subreddit is for the discussion of multiple myeloma, myeloma related news, resources, stories, and everything else associated with the disease. Common causes of low levels include: Kidney disease Liver disease Alpha-1 antitrypsin deficiency, an inherited disorder WebA Monoclonal Antibody is considered to specific to its intended target, if the Monoclonal Antibody has an S-score of at least 2.5. In: Ferri's Clinical Advisor 2019. Hi, I was in the hospital for pancreatitis three weeks ago and they said they found something on my spine and did some tests. The chance of getting MGUS grows with age, but it is not common. Purpose. If it is an abnormal band then it should have no normal levels. A gammopathy is an abnormal increase in the bodys ability to produce antibodies. Sebia, Inc; 12/2017), Immunofixation is performed with Sebia reagent sets and are specific for gamma, alpha, mu, kappa, and lambda immunoglobulin heavy and light chains. 11 The mean (SD) half-life of iomeprol in the elimination phase is 109 minutes, and it has been reported that no residual interference was observed in patients after 24 hours. Data from the Mayo Clinic showed that the median survival of MGUS patients was 8.1 years compared to 11.8 in the comparable US population. Ifx shows no monoclonal protein & free light chains are within normal range. I think I'm up to about $500 and I'm making monthly payments. During this process, laboratory technicians measure the different antibodies in your blood. -High-risk MGUS patients (M-spike >1.5, IgA or IgM, abnormal FLC ratio) have a lifetime risk of progression to MM of 60%. Proteins are found in the blood of healthy people. All rights reserved. Mayo Clinic Staff. This may lead to more tests, especially if you have no symptoms. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. If a monoclonal protein pattern is detected by IFE or FLC, a diagnosis of a monoclonal gammopathy is established. An interpretive comment is provided with the report. FLC = high lambda at 33.4mg/l Although the PEL M-spike is the recommended method of monitoring monoclonal gammopathies, IgA and IgM proteins that are contained in the beta fraction may be more accurately monitored by quantitative immunoglobulins. WebMonoclonal gammopathy of undetermined significance (MGUS. The Binding Site Group, Ltd; 06/2015). Mayo Clinic is a not-for-profit organization. This is often done with a lab test called electrophoresis. The most common condition linked with these abnormal proteins is MGUS. A number of tests may be performed that lead to the identification of M proteins. MGUS usually causes no problems. Webjbmd : There is some association of celiac disease and monoclonal gammopathy. A single copy of these materials may be reprinted for noncommercial personal use only. The Binding Site Group, Ltd; 06/2015; Optilite Freelite Lambda Free Kit. TABLE 1. In the United States, MGUS affects about 3 percent of people above age 50. WebOther monoclonal antibodies given to treat kidney diseases could also interfere with isoagglutinin. Morrow ES Jr. Allscripts EPSi. Pathology 50 years experience. WebIn some cases, myeloma isn't suspected until blood tests for other routine examinations indicate an elevated globulin level. They also make M proteins. We avoid using tertiary references. The FLC assay is specific for free kappa and lambda light chains and does not recognize light chains bound to intact immunoglobulin. Choose leaner, slightly larger cuts of meat. Most people who have M proteins in their blood dont go on to develop further health problems. The immunofixation tests showed no monoclonal proteins and the SPEP said this. 19952023 Mayo Foundation for Medical Education and Research. Plasma cell disorders. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. While a small amount is normal, a large amount of protein in urine may indicate kidney disease. If a doctor sees that your blood or urine test results show abnormal protein levels, theyll recommend further testing. They can also help decrease inflammation and, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. 86334-Immunofixation Delta and Epsilon (if appropriate), Excel | However, if the monoclonal protein falls within the beta region (most, commonly an IgA or an IgM) quantitative immunoglobulin levels may. M proteins can be found in the blood or urine through routine testing for other conditions, or they can be specifically tested for if a doctor suspects a patient has multiple myeloma. What Is Severe Combined Immunodeficiency Disease (SCID)? Proteins are an important component of all living organisms. Immunofixation electrophoresis (IFE) is performed to identify the immunoglobulin heavy chain and/or light chain. Poor dietary choices that have created low iron levels or high cholesterol levels. In: Detrick BD, Hamilton RG, Schmitz JL, eds. This process is known as electrophoresis. However, a small number of people with MGUS will develop serious cancers or conditions of the blood, such as multiple myeloma. Infection, immune system problems, and the environment may play a role. Please interpret these results within the context of all clinical and laboratory data available. Learn about its symptoms and treatment, Preauricular lymph nodes are in front of your ears and drain lymph fluid from your eyes, cheeks, and scalp near your temples. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Radiographic agents may produce an uninterpretable pattern. The most common condition linked with these abnormal proteins is monoclonal gammopathy of undetermined significance (MGUS). These cells do not fight infections, and they also can damage the kidneys. Very large IgG M-spikes (>4 g/dL) may saturate the protein stain. for Monoclonal gammopathy of undetermined significance (MGUS), Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Monoclonal gammopathy of undetermined significance (MGUS), Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. WebTesting Algorithm. They can be swollen or, Though rare, severe combined immunodeficiency (SCID) is a serious disease causing weakened immune systems in children. This is how multiple myeloma spreads. In: Goldman-Cecil Medicine. Talk to your provider about the meaning of your specific test results. Their presence is associated most commonly with a type of cancer of the plasma cells called multiple myeloma. Diagnosis is often done with a lab test called electrophoresis. What does a positive paraprotein mean? SCID is a very rare but serious congenital condition. Monoclonal gammopathy of undetermined significance is seen to be occurring when some atypical plasma cells make a protein called as M protein or paraprotein or monoclonal protein. Factors that increase your risk of developing MGUS include: Each year about 1% of people with MGUS go on to develop certain types of blood cancers or other serious diseases such as: Other complications associated with MGUS include bone fractures, blood clots and kidney problems. A total protein test measures the amount of protein present in the blood serum or urine. When kidneys are failing, the increased concentration and accumulation of substances in urine lead to a darker color which may be brown, red or purple. During gluconeogenesis in the liver pyruvate is converted to phosphoenolpyruvate? Monoclonal gammopathy of undetermined significance (MGUS) care at Mayo Clinic Your Mayo Clinic care team Mayo Clinic's MGUS teams are led by hematologists and include other specialists as needed, such as nephrologists in cases of kidney failure and cardiology in cases of amyloid involving the heart. If a monoclonal light chain is detected in the absence of an associated monoclonal heavy chain, an immunofixation electrophoresis specific for delta and epsilon chains is performed. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). -A monoclonal IgG or IgA of greater than 3 g/dL is consistent with multiple myeloma (MM). many sources of healthful fats, such as olive oil and avocados. Accessed April 18, 2019. Monoclonal gammopathy of unknown significance (MGUS) is characterised by the presence of an Purpose. For assistance, contact. The finding of an M-spike, restricted migration, or hypogammaglobulinemic PEL pattern is suggestive of a possible monoclonal protein. This site complies with the HONcode standard for trustworthy health information: verify here. Accessed April 18, 2019. This test uses an electric current to push proteins in a urine sample through a special gel. WebA characteristic monoclonal band (M-spike) is often found in the urine of patients with monoclonal gammopathies. IFE is also more sensitive than PEL for detecting small abnormalities that may be present in diseases such as light chain multiple myeloma, oligosecretory myeloma, and plasmacytomas. M-protein is an antibodyor part of an antibodythat can show up in tests of your blood and/or urine, and its presence can mean different things. Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. -Patients suspected of having a monoclonal gammopathy may have normal serum PEL patterns. Plasma cells are a type of white blood cell. A high total protein level could indicate dehydration or a certain type of cancer, such as multiple myeloma, that causes protein to accumulate abnormally. Include a high protein food with every meal. Webexcess of an abnormal immunoglobulin called monoclonal protein (or M protein). This content does not have an Arabic version. These cancerous cells rapidly spread and crowd out the normal antibodies with M proteins, overtaking the healthy cells. But experts have not found a clear link yet. If a monoclonal protein is identified, its immunoglobulin class (IgG, IgA, IgM, IgD, IgE) and light chain type (kappa, lambda) are determined by immunofixation. If myeloma is suspected as a result, your doctor tests your blood again to help Pruthi RK (expert opinion). The study (ClinicalTrials.gov, NCT04346914) is an open label, single-arm phase Ib clinical trial investigating the safety, tolerability, and efficacy of the recombinant human anti-programmed death-ligand 1 (PD-L1) monoclonal antibody Socazolimab in combination with carboplatin and etoposide in the first-line treatment of Webmonoclonal immunoglobulin: a homogeneous immunoglobulin resulting from the proliferation of a single clone of plasma cells; during electrophoresis of serum, it appears Solitary plasmacytoma (early-stage plasma cell cancer). WebLow protein levels may be caused by many conditions. The monoclonal antibodies are made of 2 types of proteins. Should vaccinated get monoclonal antibodies? This abnormal protein is formed within your bone marrow, the soft, blood-producing tissue that fills in the center of most of your bones. That's important in determining prognosis and treatment. Accessed April 18, 2019. Finding M proteins in the blood or urine is usually a sign of disease. Some insurers require referrals, or may have additional requirements for certain medical care. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause complications. Everything You Need to Know About Severe Combined Immunodeficiency (SCID). This is called electrophoresis. These are A, G, M, D and E. Your type of myeloma is named after the abnormal immunoglobulin it is making. Includes total protein, serum protein electrophoresis, and heavy-chain and light-chain typing (kappa and lambda). A sampling of topics in the following chapters: infection-related glomerulonephritis; discover of genes related to diabetic nephropathy in various animal models; glomerular basement membrane disorders in experimental models; lupus nephritis; In extramedullary plasmacytoma, immunohistochemical staining of tissue biopsies shows, ABP 980 is being developed as a biosimilar to trastuzumab, a recombinant DNA-derived humanised, Dictionary, Encyclopedia and Thesaurus - The Free Dictionary, the webmaster's page for free fun content, A Case of Hepatic Glomerulosclerosis with Monoclonal IgA1-[kappa] Deposits, Characteristics and Results of the Treatment of Multiple Myeloma in the Subject under the Age of 65 at the University Hospital of Yopougon in Abidjan, Cote d'Ivoire, A Case of Proliferative Glomerulonephritis with Monoclonal IgG Deposits That Showed Predominantly Membranous Features. WebWhat does no monoclonal protein mean? This means screening of siblings and children is not needed. Monoclonal gammopathy of undetermined significance (MGUS) care at Mayo Clinic Your Mayo Clinic care team. Your bone marrow is a soft tissue found inside most of your bones that produces blood cells. Beta1 globulin is high, beta2 and gamma are low. Drinking water will not treat the cause of protein in your urine unless you are dehydrated. This site complies with the HONcode standard for trustworthy health information: verify here. The exact cause of MGUS is not known. 1. Most people who have abnormal proteins in their blood will never get worse. WebIf your body makes M-protein, it may mean that you have one of several types of cancer, such as multiple myeloma, or another serious health problem. Ill check into financial assistance but the hospital bill for my pancreatitis is $22,000 and they didnt mention any help. Higher levels of M protein in the blood can lead to complications. This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Before your visit, write down questions you want answered. Includes total protein, serum protein electrophoresis, and heavy-chain and light-chain typing (kappa and lambda). Approximately 8% of MM patients have hypogammaglobulinemia without a quantifiable M-spike on PEL but identified by IFE and/or FLC. Goldman L, et al., eds. Another test, called immunofixation or immunoelectrophoresis, is used to determine the exact type of abnormal antibody (IgG. -A depressed gamma fraction (hypogammaglobulinemia) is consistent with immune deficiency and can also be associated with primary amyloidosis or nephrotic syndrome. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. All Rights Reserved. deficiency, hypoalbuminemia), the affected fraction is faint or absent. Our website services, content, and products are for informational purposes only. Manual of Molecular and Clinical Laboratory Immunology. Undetected antigen excess is a rare event but cannot be excluded. What to Know About IVIG (Intravenous Immunoglobulin) Infusions. While the identification of the monoclonal gammopathy is a laboratory diagnosis, the specific clinical diagnosis is dependent on a number of other laboratory and clinical assessments. If the free light chain results do not agree with other clinical or laboratory findings, or if the sample is from a patient that has previously demonstrated antigen excess, the result must be checked by retesting at a higher sample dilution. Diagnosis. Mayo Clinic is a not-for-profit organization. The type of immunoglobulin this is varies from person to person. WebIf a monoclonal light chain is detected in the absence of an associated monoclonal heavy chain, immunofixation electrophoresis specific for delta and epsilon chains is performed, if not previously performed, or at the discretion of the laboratory director reviewing the case. -In the hereditary deficiency of a protein (eg, agammaglobulinemia, alpha-1-antitrypsin [A1AT] deficiency, hypoalbuminemia), the affected fraction is faint or absent. 425 East 61st St8th Floor Once this abnormal cell forms, it begins to multiply rapidly and does not die as a normal cell does. A decrease or increase of the M-spike that is greater than 0.5 g/dL is considered a significant change. Sometimes, it may also occur in Hodgkin's disease. Myeloma is a cancer of the plasma cells. These proteins can also be referred to as an M-spike, monoclonal immunoglobulin, or paraprotein. 8th ed. By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. Press question mark to learn the rest of the keyboard shortcuts. Method Name Only orderable as part of a profile. Monoclonal gammopathies are conditions in which abnormal proteins are found in the blood. Fax: (212) 746-8961, Toggle Research and Clinical Trials menu options, About Multiple Myeloma, Amyloidosis, and Other Plasma Cell Disorders, Risk Factors for Multiple Myeloma and Other Plasma Cell Disorders, Diagnosing Multiple Myeloma and Other Plasma Cell Disorders, Multiple Myeloma and Plasma Cell Disorder Treatment. A small number of patients with myeloma have either oligosecretory disease, in which the detectable level of monoclonal protein is low, or nonsecretory disease, in which no monoclonal protein can be detected. Multiple myeloma (plasma cell cancer, which may be kappa or lambda light chain myeloma). High-risk MGUS patients (M-spike >1.5, IgA or IgM, abnormal FLC ratio) have a lifetime risk of progression to MM of 60%. No abstract available. If you have high amounts of this protein in your blood, it's important to have regular checkups so that you can get earlier treatment if it does progress. Though these -Low-risk MGUS patients are defined as having an M-spike of less than 1.5 g/dL, IgG monoclonal protein, and a normal FLC K/L ratio (0.25-1.65), and these patients have a lifetime risk of progression to MM of less than 5%. If you are experiencing bone pain, your doctor might recommend an MRI or ositron emission tomography (PET) scan. Their presence is associated most commonly with a type of cancer of the plasma cells called multiple myeloma. These are the cells that help fight off infection, so myeloma patients are immune-compromised. WebA Monoclonal Antibody is considered to specific to its intended target, if the Monoclonal Antibody has an S-score of at least 2.5. Know why a new medicine or treatment is prescribed, and how it will help you. The lab treats the gel to keep only certain proteins. Antibodies are produced naturally by your body and help the immune system recognize germs that A monoclonal band (M-spike) on serum and/or urine PEL identifies a monoclonal process and quantitates the abnormality. PHP Pdf | Masks are required inside all of our care facilities. Mayo Clinic has a long history of researching this condition, so its specialists have extensive experience distinguishing MGUS from related disorders. Monoclonal Gammopathy of Unknown Significance (MGUS), Patient Preparation: Fasting preferred but not required. Learn more about appointments at Mayo Clinic. Let's look at symptoms and, Cytokine release syndrome is an immune system response that can occur due to immunotherapy or infection. The study (ClinicalTrials.gov, NCT04346914) is an open label, single-arm phase Ib clinical trial investigating the safety, tolerability, and efficacy of the recombinant human anti-programmed death-ligand 1 (PD-L1) monoclonal antibody Socazolimab in combination with carboplatin and etoposide in the first-line treatment of Finding M proteins in the blood or urine is usually a sign of disease. Because MGUS is not harmful, it doesnt need to be treated. Unusual levels of proteins may also be found during routine urine tests. So when the Serum Protein Electrophoresis (SPEP) test shows a spike in M protein, this is a sign of MM. MGUScauses no symptoms. WebQuantitative determination of the serum M component to demonstrate that an IgG or IgM monoclonal protein is less than 3.0 g/dL or an IgA monoclonal protein is less than 2.0 (Package insert: Sebia Hydrasys Hydragel 1, 2, 4, 9IF, Sebia Inc; 09/2015), The quantitation of free light chain (FLC) by turbidimetry uses FLC antisera. Press J to jump to the feed. There is something called MGUS, or monoclonal gammopathy of uncertain significance--which means that physicians can make guesses about what this means to you in the long-term but can't tell you for sure. Monoclonal gammopathy of undetermined significance (MGUS). A monoclonal IgM of greater than 3 g/dL is consistent with macroglobulinemia. Monoclonal gammopathy of undetermined significance (MGUS). Waldenstrm macroglobulinemia (a rare type of blood cancer). However, if the monoclonal protein falls within the beta region (most commonly an IgA or an IgM) quantitative immunoglobulin levels may be more a useful tool to follow the monoclonal protein level than PEL. When the body produces abnormal antibodies, they are called monoclonal proteins, or M proteins. Multiplying by the serum total protein converts the percentage of protein in each fraction into serum concentration. If a monoclonal light chain is detected in the absence of an associated monoclonal heavy chain, an immunofixation electrophoresis specific for delta and epsilon chains is performed. (Package insert: Hydragel 30 Protein [E]. There is no risk of monoclonal gammopathies in first-degree family members. All appointments are prioritized on the basis of medical need. lin a homogeneous immunoglobulin resulting from the proliferation of a single clone of plasma cells; during electrophoresis of serum, it appears Dr. Gurmukh Singh answered. Their main job is to fight off infection. Long-term damage to your kidneys may be corrected by restricting protein, if you are diabetic, or experiencing kidney problems. Frequent blood tests and checkups at your doctors office can help you stay on top of this disease. Reference values have not been established for patients that are younger than 16 years of age, Immunofixation: No monoclonal protein detected. CMS Pdf, Normal Reports | A urine protein test measures the amount of protein in urine. High blood protein is not a specific disease or condition in itself, but it might indicate you have a disease. A single copy of these materials may be reprinted for noncommercial personal use only. 2005-2023 Healthline Media a Red Ventures Company. However, you shouldnt have a lot of protein in your urine. What does no monoclonal protein detected mean? WebUrine immunofixation uses electricity to push proteins from your urine sample through a kind of gel. Web1. AskMayoExpert. https://www.uptodate.com/contents/search. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). It involves placing a sample of the liquid part of your blood (called serum) into a gel thats exposed to an electric current. The initial identification of an IgM, IgA, or IgG M-spike greater than 4 g/dL, greater than 5 g/dL, and greater than 6 g/dL, respectively, should be followed by VISCS / Viscosity, Serum. Moreover, high-protein/high-meat diets may also be associated with increased risk for coronary heart disease due to intakes of saturated fat and cholesterol or even cancer [31]. When youre healthy, plasma cells (a type of white blood cell) in your bodys bone marrow help your body fight infections by producing antibodies that find and attack germs. This has to be examined carefully. Mayo Clinic in Rochester, Minnesota, and Mayo Clinic in Phoenix/Scottsdale, Arizona, are ranked among the Best Hospitals for cancer by U.S. News & World Report. The But sometimes it can progress to more-serious diseases, including some forms of blood cancer. Having all of this specialized expertise in a single place, focused on you, means that you're not just getting one opinion care is discussed among the team, your test results are available quickly, and appointments are coordinated so that you can get answers in a matter of days. Know how to contact your provider if you have questions. WebOther monoclonal antibodies given to treat kidney diseases could also interfere with isoagglutinin. But it appears to begin with one abnormal plasma cell in the bone marrow. WebWhat does no monoclonal protein mean? I did this until I was able to get insurance and refused the big stuff until then. Mayo Clin Proc. WebMonoclonal gammopathy of undetermined significance or MGUS (abnormal proteins in the blood; it can progress to cancer). These diseases and conditions include: Chronic kidney disease Diabetic nephropathy (kidney disease) WebSummary: If a monoclonal protein is identified, its immunoglobulin class (IgG, IgA, IgM, IgD, IgE) and light chain type (kappa, lambda) are determined by immunofixation. The presence of M protein in the blood typically indicates the presence of multiple myeloma, or other plasma cell disorders such as amyloidosis or MGUS. These tests may include: Doctors often find M proteins in the blood while testing for other conditions that affect the bloods protein levels, such as nervous system disorders. To find these identical M proteins, your doctor might run a blood test called serum protein electrophoresis (SPEP). Multiple myeloma. Other blood and urine tests can tell you more, a biopsy and imaging scans even more. Amyloidosis can affect the heart, kidneys, liver, spleen, nervous system, stomach or intestines. (2017). The more M proteins in your blood and the longer youve had MGUS, the higher your risk of developing one or more related conditions. Includes total protein, serum protein electrophoresis, and heavy-chain and light-chain typing (kappa and lambda). -A decreased albumin (<2 g/dL), increased alpha-2 fraction (>1.2 g/dL), and decreased gamma fraction (<1 g/dL) is consistent with nephritic syndrome and, when seen in an adult older than 40 years, should be followed by MPSU / Monoclonal Protein Study, 24 Hour, Urine. -A characteristic monoclonal band (M-spike) is often found on protein electrophoresis (PEL) in the gamma globulin region and, more rarely, in the beta or alpha-2 regions. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. In blood cancers such as myeloma, the 'M' in 'M protein' stands for monoclonal. Cytokine Release Syndrome: Symptoms, Causes, Treatments. Also know what the side effects are. This abnormal protein is formed within your bone marrow, the soft, blood-producing tissue that fills in the center of most of your bones. Tests to identify protein in urine are critical for diagnosing and screening for diseases of the kidneys or other conditions affecting kidney function. -After the initial identification of a monoclonal band, quantitation of the M-spike on follow-up PEL can be used to monitor the monoclonal gammopathy.