Levinson SS. Strengths and weaknesses of methods for identifying monoclonal free light chains of Ig: examples from two cases with renal disease.
Clin Chem Lab Med 2017;
54:1039-43. [PMID:
26368046 DOI:
10.1515/cclm-2015-0482]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 07/12/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND
Serum free light chain (FLC) analysis with ratio and urine immunofixation electrophoresis (IFE) are both available for routine use in helping to detect plasma cell dyscrasia and related diseases.
CASES
Case reports showing one serum positive for serum FLC but that showed a hook effect and overestimated the amount of monoclonal FLC while urine IFE was negative for Bence Jones protein, and a second serum that showed elevated FLC κ and λ but a normal κ/λ ratio, while urine IFE was positive for Bence Jones protein.
CONCLUSIONS
These two techniques complement one another. Neither of the techniques is truly quantitative, and both exhibit methodological defects.
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