Document Detail

Screening for M-proteinemia: serum protein electrophoresis and free light chains compared.
MedLine Citation:
PMID:  19842994     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The objective of this study was to evaluate the efficiency of free light chain (FLC) analysis in comparison to serum protein electrophoresis (SPE) for detecting M-proteinemia. METHODS: A total of 553 consecutive patients for whom evaluation of M-proteinemia was requested were included in this study. For all patients, serum FLC analysis and SPE followed by pentavalent immunofixation analysis was performed. Identification of monoclonal bands was performed using specific antisera. FLC analysis was performed using the Modular P analyzer in accordance with the manufacturer's recommendations. Local reference ranges for FLCs on this platform were established based on samples from patients with a normal electrophoretic pattern [no monoclonal bands, no hypo- or hypergammaglobulinemia, no acute phase pattern and normal kidney function, i.e., estimated glomerular filtration rate (eGFR) >60 mL/min]. RESULTS: Local reference ranges (95%) were established (n=243): kappa: 8.01-28.26 mg/L; lambda: 8.07-23.58 mg/L and kappa/lambda ratio: 0.74-1.66. Negative and positive predictive values were 98.6% and 49.5%, respectively, for screening for M-proteinemia by SPE alone, 94.3% and 21.7% for FLC concentration and 95.1% and 21.4% for FLC with the kappa/lambda-ratio included. Combining protein electrophoresis and FLCs resulted in a negative predictive value of 99.0% and a positive predictive value of 23.4%. CONCLUSIONS: Serum FLC analysis alone is not suitable for screening for M-proteinemia.
Andries J Bakker; Ageeth Bierma-Ram; Coby Elderman-van der Werf; Marcia L Strijdhaftig; Jelmer J van Zanden
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical chemistry and laboratory medicine : CCLM / FESCC     Volume:  47     ISSN:  1434-6621     ISO Abbreviation:  Clin. Chem. Lab. Med.     Publication Date:  2009  
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9806306     Medline TA:  Clin Chem Lab Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1507-11     Citation Subset:  IM    
Department of Clinical Chemistry, Klinisch Chemisch Laboratorium, Leeuwarden, The Netherlands.
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MeSH Terms
Chromatography, Liquid
Electrophoresis / methods*
Glycoproteins / blood*
Reg. No./Substance:
0/Glycoproteins; 0/protein M (glycoprotein)

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