Journal d'hématologie et des maladies thromboemboliques
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Double Gammopathy of Undetermined Significance-A First Case Report from Pakistan

Khalid A and Shahbaz I

Monoclonal Gammopathies are a group of disorders that show high levels of a monoclonal immunoglobulin (Mprotein). It is produced by a clone of abnormally proliferating B-lymphocytes and/or plasma cells. This M-protein can be evaluated by Serum or Urine Protein Electrophoresis (SPEP), which yields a single distinct band (M-band), usually in the gamma globulin region. Rarely two separate M-bands appear simultaneously at different positions during SPEP–A condition known as Biclonal Gammopathy, as a result of clonal expansion of two dissimilar neoplastic cell lines. Here, we report an atypical case of plasma cell dyscrasias where two distinct bands were found in gamma region during SPEP depicting biclonalgammopathy in gamma region. This peculiar presentation of double M bands in gamma region was double gammopathy without any underlying plasma cell or Lymphoproliferative disorder. This unusual case of double Gammopathy is referred to as “Biclonal Gammopathy” with undetermined significance. To the best of our knowledge this is the first case of double Gammopathy to be reported from Pakistan.