Figure 319

Serum (S) and urine (U) proteins in patients with primary systemic amyloidosis in an 11-year study at the Mayo Clinic. Immunoelectrophoresis or immunofixation of serum and appropriate concentrations in urine showed a monoclonal protein in nearly 90% of patients. In the absence of monoclonal protein, one must search for a monoclonal population of plasma cells in the bone marrow or perform immunohistochemical staining to identify the type of amyloid. (From Kyle and Gertz [5]; with permission.)

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