IgM (Immunoglobulin M)

Pathogenic paraprotein causing end-organ damage

Expression
Elevated (monoclonal)
Evidence level
established

Role in pathogenesis

Monoclonal IgM is the effector molecule responsible for most WM complications. Its large pentameric structure causes hyperviscosity. Anti-MAG IgM causes neuropathy. IgM can also form cryoglobulins, cold agglutinins, or deposit as amyloid. IgM level is a treatment response marker.