Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2017: 3.556

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

Online
ISSN
1437-4331
See all formats and pricing
More options …
Volume 49, Issue 7

Issues

Monoclonal gammopathy missed by capillary zone electrophoresis

Christof Schild / Florence Egger
  • Institute of Clinical Chemistry, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Alain Kaelin-Lang / Jean-Marc Nuoffer
  • Institute of Clinical Chemistry, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2011-05-17 | DOI: https://doi.org/10.1515/CCLM.2011.189

Abstract

Background: Serum protein electrophoresis is used as a screening test for monoclonal gammopathies. Here, we present a case of a high-concentration monoclonal immunoglobulin (M-protein) that was missed by serum protein electrophoresis on a Capillarys 2 capillary zone electrophoresis system. The aim of our study was to identify the reason for the failure of the system to detect the M-protein.

Methods: M-protein solubility was examined in response to temperature, pH, ionic strength, the chaotropic agent urea and the reducing agent 2-mercaptoethanol.

Results: Precipitation of the M-protein was not cold-induced, but solubility decreased at pH 8.5 or higher, when the pH approached the apparent isoelectric point. The M-protein also precipitated in alkaline Capillarys 2 electrophoresis buffer (pH 10), which was the reason for the false-negative electrophoresis result. Precipitation of the M-protein was not related to the ionic strength of the buffer. Solubility improved in presence of urea. Pre-treatment of serum with 2-mercaptoethanol revealed the missing M-protein peak of 36 g/L on the electropherogram.

Conclusions: This case shows that insolubility of M-proteins in alkaline buffer is one possible cause of false-negative results on capillary zone electrophoresis systems. False-negative results should be considered, especially when accompanying laboratory results are inconsistent with the electropherogram.

Keywords: capillary zone electrophoresis; gammopathy; monoclonal components; monoclonal proteins

About the article

Corresponding author: Christof Schild, Institute of Clinical Chemistry, Inselspital, 3010 Bern, Switzerland Fax: +41-31-632-48-62


Received: 2010-11-15

Accepted: 2011-02-14

Published Online: 2011-05-17

Published in Print: 2011-07-01


Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 49, Issue 7, Pages 1217–1219, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2011.189.

Export Citation

©2011 by Walter de Gruyter Berlin Boston.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Donald F. LeGatt, George B. Blakney, Trefor N. Higgins, Kareena L. Schnabl, Carol E. Shalapay, Valerian C. Dias, and James C. Wesenberg
Therapeutic Drug Monitoring, 2012, Volume 34, Number 3, Page 306

Comments (0)

Please log in or register to comment.
Log in