2016
DOI: 10.1515/cclm-2015-0862
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Challenges of measuring monoclonal proteins in serum

Abstract: Abstract:The measurement of monoclonal protein (M-protein) is vital for stratifying risk and following individuals with a variety of monoclonal gammopathies. Direct measurement of the M-protein spike by electrophoresis and immunochemical measurements of specific isotypes or free light chains pairs has provided useful information about the quantity of M-protein. Nonetheless, both traditional electrophoresis and immunochemical methods give poor quantification with M-proteins smaller than 10 g/L (1 g/dL) when in … Show more

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Cited by 61 publications
(54 citation statements)
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“…A total protein measurement is needed to convert protein fraction percentages into a gravimetric protein measurement . Often laboratories will use the biuret, Lowery, or other automated dye‐binding protein assays already in place on their chemistry analyzer to determine the total protein in serum samples submitted for electrophoresis .…”
Section: Methodsmentioning
confidence: 99%
See 1 more Smart Citation
“…A total protein measurement is needed to convert protein fraction percentages into a gravimetric protein measurement . Often laboratories will use the biuret, Lowery, or other automated dye‐binding protein assays already in place on their chemistry analyzer to determine the total protein in serum samples submitted for electrophoresis .…”
Section: Methodsmentioning
confidence: 99%
“…With this technique, the sample is incubated with an antibody against the target molecule(s) prior to electrophoresis. When electrophoresed, the target molecule‐labeling immunoglobulin complexes have altered migration, causing a relative void in the electrophoretogram when compared with the electrophoretogram of the sample without labeling . In effect, the target protein has been subtracted from the electrophoretogram.…”
Section: Methodsmentioning
confidence: 99%
“…Dado que existen pocas causas de hipogammaglobulinemia, (inmunodeficiencias, posterior a fármacos como rituximab), este hallazgo en la EFP sumado a una clínica compatible, debe hacer sospechar en una GM como la primera causa. Es decir, un paciente que presenta hipogammaglobulinemia y alta sospecha clínica, obliga a buscar la paraproteína con técnicas más sensibles 4 .…”
Section: Interpretaciónunclassified
“…In this next group of papers and case reports on PCD, Keren and Schroeder begin by reviewing the electrophoretic and immunochemical methods that have been used over the years to quantify M-proteins in serum [11]. They explore the limitations of past and current methods and describe new methods to improve the accuracy of measurement of low-concentration M-proteins and quantify isotype-specific immunoglobulin classes, and liquid chromatography-tandem mass spectrometry to obtain more analytically sensitive measurements of residual M-protein.…”
Section: Section 2: Serum and Urine Protein Electrophoresis And Immunmentioning
confidence: 99%
“…As discussed in Section 2 [11], one way to improve the accuracy of measurement of low-concentration M-proteins includes use of immunoassays that quantify isotype-specific immunoglobulin classes. In their "Point" paper, Evans et al [31] describe the advantages of using IgA-κ and IgA-λ heavy/light chain (HLC) assays as a more accurate method for quantification of monoclonal IgA proteins that overlap normal proteins in the β-region on electrophoresis.…”
Section: Section 4: New Laboratory Assays and Challengesmentioning
confidence: 99%