Componenti monoclonali piccole ma dannose

A small B-cell clone can synthesize a toxic monoclonal protein that causes severe organ damage. Diseases caused by these toxic immunoglobulins range from AL amyloidosis, light chain deposition disease and cryoglobulinemia to the POEMS (Polineuropathy, Organomegaly, Endocrinopathy, Monoclonal protein and Skin changes) syndrome. The serum monoclonal components are, in these cases, usually small and difficult to be detected by the commercially available methods. However, an early detection and a correct characterization of the monoclonal component is essential, because misdiagnosis or a delay in diagnosis can prevent the proper treatment of the patient worsening his outcome. Here we present two cases of amyloidosis AL, where the correct diagnosis was facilitated by specific and sensitive techniques. This does not mean that every clinical laboratory should be competent in this field and use these methods routinely, but simply that people should be aware of the problem, so that these clinical conditions can be properly managed.