The Missing M Band: Is it Really Non Secretory Multiple Myeloma?

It is well-known that the sequence of diagnostic investigations plays a crucial role in the timely diagnosis and management of patients. However, in this case it was a faulty sequence of ordering investigations which prolonged the hospital stay and delayed therapeutic intervention for the patient concerned. Serum Protein Electrophoresis (SPE), Immunofixation electrophoresis (IFE) and sFLC are simple blood-based tests which can help diagnose a majority of cases of monoclonal gammopathies. They need to be included as first line tests in our approach to evaluating a suspected case of monoclonal gammopathy.