31st May 2023

An 80-year-old male is found to have an elevated total protein in routine bloods and goes on to have further investigations

An 80-year-old male is found to have an elevated total protein in routine bloods and goes on to have further investigations.


Hb	145 g/L	(130-180 g/L)	IgG kappa paraprotein 36g/L detected
WCC	8.1 x 10⁹/L	(3.6-11 x 10⁹/L)	IgG	40 g/L	(6-16 g/L)
Platelets	275 x 10⁹/L	(150-400 x 10⁹/L)	IgA	2.0 g/L	(0.8-3 g/L)
Adj. Ca	2.3 mmol/L	(2.2-2.6 mmol/L)	IgM	1.1 g/L	(0.4-2.5 g/L)
Urea	5.4 mmol/L	(2.5-7.8 mmol/L)	Kappa light chains	148 mg/L	(3.3-19.4 mg/L)
Creatinine	74 µmol/L	(59-104 µmol/L)	Lambda light chains	8.5 mg/L	(5.7-26.3 mg/L)
eGFR 88 ml/min/1.73m2			Kappa/lambda ratio	17.4	(0.26-1.65)

A bone marrow is performed which demonstrates a clonal population of plasma cells, making up 30% of cells.

A whole-body MRI is performed which demonstrates no evidence of lytic lesions.

Based on the above information, what is the diagnosis?

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