Free light chains are proteins produced by B lymphocytes during the process of antibody synthesis. Their production, as a reflection of B cell activation, can give insight into the activity of the adaptive immune system. In recent years, an automated immunoassay that provides quantitative measurement of free light chains in the serum has been developed. This assay has not only revolutionised the investigation of monoclonal light chain overproduction in plasma cell diseases, but has also allowed for the quantification of polyclonal free light chains in serum. The discovery of high levels of polyclonal free light chains in a number of inflammatory and auto-immune conditions has led to the examination of their value as a biomarker of disease activity. Research into their bio-activity has also highlighted their potential role in the pathogenesis of inflammatory disease, making them an attractive target for novel therapies.

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despite evidence to suggest they should be considered. We have also discovered that ADO and GSF are strong prognostic indicators for this cohort, although their application may not be appropriate (only two patients of the DNR group had a predicted 3-year mortality >50% on ADO index). This may reflect other factors (such as patient choice) that we have not evaluated. We feel that as many prognostic factors as available should be considered when making decisions on resuscitation as ultimately, this may also be the decision not to intubate.

those sending samples, including surgeons and radiologists performing biopsies, so that specimens are sent correctly. Abstract P59 Table 1 Results Pulmonary tuberculosis (N[36)Extra-pulmonary tuberculosis (N[33) Total (N[69)