Open AccessQuantitation of Kappa and Lambda Light Chains for the Detection of Monoclonal Gammopathy
Author(s) -
Sun Tsieh,
De Szalay Helga,
Lien York Y.,
Chang Victor
Publication year - 1988
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.1860020204
Subject(s) - immunoglobulin light chain , kappa , monoclonal gammopathy , immunofixation , gammopathy , monoclonal gammopathy of undetermined significance , serum protein electrophoresis , medicine , paraproteinemias , immunoelectrophoresis , monoclonal , polyclonal antibodies , hypogammaglobulinemia , antibody , monoclonal antibody , immunology , mathematics , geometry
This study compared the quantitation of immunoglobulins and light chains with qualitative analysis by immunoelectrophoresis and immunofixation to determine the usefulness of these techniques for the detection of monoclonal gammopathy. Emphasis was on the recently available nephelometric technique for light chain quantitation. Quantitation of immunoglobulins and light chains correctly typed 142 of 159 cases of monoclonal gammopathy. False‐negative results were only seen in 17 cases of minimonoclonal gammopathies (IgG‐kappa, IgG‐lambda, and kappa light chain), in which either the quantitation of light chains or of immunoglobulins, or the kappa/lambda ratio remained normal. Among 92 control cases, abnormal kappa/lambda ratios were seen in three AIDS patients, two cases of polyclonal gammopathy, and one case of hypogammaglobulinemia, but none of them were misdiagnosed as monoclonal gammopathy by quantitation. For clinical laboratories, quantitative assays have some advantages over qualitative analysis because they are less demanding with respect to technique and interpretation, and they allow earlier result reporting and discernment in patients' follow‐ups. Qualitative analysis should be reserved for equivocal cases.