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Licensed Unlicensed Requires Authentication Published by De Gruyter February 22, 2014

Combined light chain immunofixation to detect monoclonal gammopathy: a comparison to standard electrophoresis in serum and urine

  • Wessel Jenner , Sandra Klingberg , Jill R. Tate , Urs Wilgen , Jacobus P.J. Ungerer and Carel J. Pretorius EMAIL logo


Background: The purpose of this study was to evaluate a combined κ and λ light chain immunofixation (CLIF) as a screening tool to detect monoclonal immunoglobulins in serum and urine. A secondary aim was to investigate the impact on workflow and reagent utilisation of a systematic implementation of CLIF in addition to routine protein electrophoresis (PE) on all samples.

Methods: Light chain antisera (κ and λ) were mixed in a 1:1 ratio and loaded in the same sequence as the PE to create a superimposable image.

Results: The CLIF procedure agreed significantly better with standard immunofixation procedures in the serum and urine. In 33 (22%) new patients and in 114 (15%) follow-up patients CLIF detected a band missed by PE in serum. In 34 (4.5%) of previously categorised cases the monoclonal band was below the detection limit of CLIF in serum, but still detectable by conventional immunofixation electrophoresis. In one case (0.7%) a band in a urine specimen was missed by CLIF compared to 70 (49%) missed by PE. After the systematic introduction of CLIF turn-around-times (TATs) and utilisation of laboratory consumables decreased significantly (p<0.001).

Conclusions: A systematic implementation of CLIF led to the detection of monoclonal bands missed by PE with an improvement in TATs and a decrease in cost.

Corresponding author: Carel J. Pretorius, Department of Chemical Pathology, Block 7, Floor 3, Herston Hospitals Campus, Herston, 4029, QLD, Australia, Phone: +617 36460083, Fax: +617 36461392, E-mail:


We thank Rehna Gous, Elzahn de Waal, Katie Buzacott, Matt Burke, Izabela Valentine, Nick Avsenev, Anfernee Tseng, Bozena Gluchowska and Linden Callaghan for technical support and data collection.

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.


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Received: 2014-1-6
Accepted: 2014-1-28
Published Online: 2014-2-22
Published in Print: 2014-7-1

©2014 by Walter de Gruyter Berlin/Boston

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