Discrimination of Monoclonal Gammopathy Using Immunoassay for Free Light Chain
단클론성 감마글로불린병증 감별을 위한 유리형 경쇄측정
박, 일중; 조, 성란; 이, 위교
Annals of laboratory medicine, 24(2):91-95, 2004
Annals of laboratory medicine
Background : Immunoglobulins exist in the serum, mostly in a union type of heavy and light chains. Free light chain types exist in an extremely small quantity and are useful in the diagnosis and follow up of multiple myeloma, but are also increased in autoimmune diseases such as SLE. The aim of this study was to evaluate the usefulness of the serum free light chain in discriminating between mono￢clonal and polyclonal gammopathy.
Methods : Between January and June of 2003. we identified 15 patients with monoclonal gam￢mopathy and 12 patients with polyclonal gammopathy on serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE). We measured the serum concentration of the free light chain using Beckman Coulter IMMAGE™ analyzer with FREELITE™ reagents and calculated the kappa/lamb￢da (?/?) ratio. We also measured the free light chain of 35 healthy controls to establish a reference range.
Results : The reference ranges established in this study were 4.97-12.84 mg/L for kappa light chains, 6.71-18.09 mg/L for lambda light chains, and 0,46-1.01 for the ?/?ratio. The free light chains were abnormal in all 27 but 2 patients with polyclonal gammopathy on SPEP. The ?/? ratio was abnormal in 12 of the 15 patients with monoclonal gammopathy and in none of the 12 patients with polyclonal gammopathy.
Conclusions : Our results suggest that the ?/? ratio can be a useful tool to discriminate between monoclonal and polyclonal gammopathy, especially in the case of vague SPEP results, or when mon￢oclonal gammopathy is suspected in SPEP.
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