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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 2017: 2.34

SCImago Journal Rank (SJR) 2017: 1.114
Source Normalized Impact per Paper (SNIP) 2017: 1.188

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Volume 54, Issue 6


Strengths and weaknesses of methods for identifying monoclonal free light chains of Ig: examples from two cases with renal disease

Stanley S. Levinson
  • Corresponding author
  • Department of Veteran Affairs Medical Center, University of Louisville, Louisville, KY, USA
  • Department of Medicine, Section of Endocrinology, University of Louisville, Louisville, KY, USA
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2015-09-12 | DOI: https://doi.org/10.1515/cclm-2015-0482


Background: Serum free light chain (FLC) analysis with ratio and urine immunofixation electrophoresis (IFE) are both available for routine use in helping to detect plasma cell dyscrasia and related diseases.

Cases: Case reports showing one serum positive for serum FLC but that showed a hook effect and overestimated the amount of monoclonal FLC while urine IFE was negative for Bence Jones protein, and a second serum that showed elevated FLC κ and λ but a normal κ/λ ratio, while urine IFE was positive for Bence Jones protein.

Conclusions: These two techniques complement one another. Neither of the techniques is truly quantitative, and both exhibit methodological defects.

Keywords: free light chains; immunofixation electrophoresis; serum; urine


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About the article

Corresponding author: Stanley S. Levinson, Pathology and Laboratory Medicine, Robley Rex VA Medical Center, 800 Zorn Avenue, Louisville, KY 40206, USA; Department of Veteran Affairs Medical Center, University of Louisville, Louisville, KY, USA; and Department of Medicine, Section of Endocrinology, University of Louisville, Louisville, KY, USA

Received: 2015-05-19

Accepted: 2015-07-12

Published Online: 2015-09-12

Published in Print: 2016-06-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 54, Issue 6, Pages 1039–1043, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2015-0482.

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