Immunoglobulins and Laboratory Recognition of Monoclonal Proteins

Katzmann, Jerry A.; Kyle, Robert A.; Lust, John A.; Snyder, Melissa R.; Dispenzieri, Angela

doi:10.1007/978-1-4614-3764-2_29

Cited by 5 publications

(7 citation statements)

References 167 publications

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“…Light chains are normally produced by plasma cells in molar excess to heavy chains. In normal individuals approximately 500 mg of FLC are synthesized each [36]. Quantitative FLC assays use antisera directed against epitopes that are exposed only when the light chains are free (unbound to heavy chain) in solution.…”

Section: Free Light Chains (Flc) or Bence Jones Protein Quantitationmentioning

confidence: 99%

“…In addition, monoclonal proteins in urine may present as wider bands in electrophoresis than in serum, usually due to degradation and longer application time in the gel. Occasionally there may be two discrete light chain bands, which may be a monoclonal light chain plus a monoclonal immunoglobulin or fragment from serum, or monomers and dimers of the same monoclonal light chain in the absence of a corresponding heavy chain [36]. Also, if heavy chain disease is suspected from serum IFE, urine IFE is a useful confirmatory test.…”

Section: Urine Assaysmentioning

confidence: 99%

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Laboratory testing requirements for diagnosis and follow-up of multiple myeloma and related plasma cell dyscrasias

Willrich

Katzmann

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:Monoclonal immunoglobulins are markers of plasma cell proliferative diseases and have been described as the first (and perhaps best) serological tumor marker. The unique structure of each monoclonal protein makes them highly specific for each plasma cell clone. The difficulties of using monoclonal proteins for diagnosing and monitoring multiple myeloma, however, stem from the diverse disease presentations and broad range of serum protein concentrations and molecular weights. Because of these challenges, no single test can confidently diagnose or monitor all patients. Panels of tests have been recommended for sensitivity and efficiency. In this review we discuss the various disease presentations and the use of various tests such as protein electrophoresis and immunofixation electrophoresis as well as immunoglobulin quantitation, free light chain quantitation, and heavy-light chain quantitation by immuno-nephelometry. The choice of tests for inclusion in diagnostic and monitoring panels may need to be tailored to each patient, and examples are provided. The panel currently recommended for diagnostic screening is serum protein electrophoresis, immunofixation electrophoresis, and free light chain quantitation.

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Section: Free Light Chains (Flc) or Bence Jones Protein Quantitationmentioning

confidence: 99%

Section: Urine Assaysmentioning

confidence: 99%

Laboratory testing requirements for diagnosis and follow-up of multiple myeloma and related plasma cell dyscrasias

Willrich

Katzmann

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…True biclonal gammopathies may result either from neoplastic proliferation of two different ''clonally unrelated'' malignant plasma cell lines or from the existence of a single clone of B-lymphoid cells, which subsequently diversifies into two independent clones after a process of antigenic selection [1]. Accordingly, the clonal proteins being secreted always have a ''different variable region and differ in both light chain and heavy chain class''.…”

Section: True Biclonal Gammopathiesmentioning

confidence: 99%

“…On the other hand, the pentameric IgM can break down into 7 s subunits, which show up on electrophoresis as one or more 'extra' monoclonal bands. These multiple bands are most likely due to various molecular forms of a monoclonal protein derived from a single plasma cell clone [1].…”

Section: Does a Double Band Always Signify Biclonal/ Double Gammopathy?mentioning

confidence: 99%

“…This can be found mainly in monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma (MM), or Waldenström's macroglobulinemia. However, monoclonal proteins may also occur in primary amyloidosis, cryoglobulinemia, lymphoproliferative disorders, solitary plasmacytoma, certain infections such as Hepatitis C virus (HCV) infection, and in even rare conditions like, POEMS syndrome and scleromyxedema [1].…”

Section: Introductionmentioning

confidence: 99%

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Occurrence of Double Monoclonal Bands on Protein Electrophoresis: An Unusual Finding

Srinivasan

Bhagat

Bansal

et al. 2015

Indian J Hematol Blood Transfus

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Various techniques of protein electrophoresis are used for detection of monoclonal proteins/paraproteins in serum and/or urine of patients with monoclonal gammopathies. These are detected as the so-called 'M' bands (monoclonal bands) on serum protein electrophoresis and/ or immunofixation electrophoresis. In most cases, a single M-band is detected. However, more than one M-band can be detected in the samples of a minor proportion of patients. This condition is termed as 'double gammopathy' or 'biclonal gammopathy'. A knowledge of such an unusual occurrence is essential for recognition and appropriate interpretation of this entity.

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