gammapatia monoclonal igm kappaigm kappa monoclonal gammopathyigm kappa monoclonal proteinigm kappa monoclonal band presentgammapatia monoclonal igmigm kappaigm monoclonal gammopathyigm monoclonal proteinmonoclonal igm lambdaigm kappa monoclonaligm kappa monoclonal protein detectedmonoclonal gammopathy igm kappa type