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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

Online
ISSN
1437-4331
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Volume 54, Issue 6

Issues

Multiple qualitative and quantitative methods for free light chain analysis are necessary as first line tests for AL amyloidosis

Peter Sečník Jr.
  • Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
  • Third Faculty of Medicine, Charles University, Prague, Czech Republic
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Eva Honsová
  • Department of Clinical and Transplantation Pathology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Antonín Jabor
  • Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
  • Third Faculty of Medicine, Charles University, Prague, Czech Republic
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Petra Lavríková
  • Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
  • Third Faculty of Medicine, Charles University, Prague, Czech Republic
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Janka Franeková
  • Corresponding author
  • Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
  • Third Faculty of Medicine, Charles University, Prague, Czech Republic
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2016-01-13 | DOI: https://doi.org/10.1515/cclm-2015-0816

Abstract

The objective of this study was to demonstrate the necessity of using different methods for amyloidogenic light chain detection. Serum and urine agarose gel electrophoresis and immunofixation, as well as serum free light chain (FLC) immunoassay measurements, were evaluated in a patient with verified multiple myeloma and consequent AL amyloidosis confirmed by Congo red staining and immunofluorescence techniques. Conventional chemistry tests [serum and urine electrophoresis (SPE and UPE); serum and urine immunofixation (SIFE and UIFE)] were inconclusive. Only quantitative FLC immunoassay (serum free light chain immunoanalysis, SFLC) provided correct diagnostic information. A combination of gel-based SIFE and UIFE with more novel quantitative FLC immunoassays appears necessary when searching for monoclonal immunoglobulin light chain-related diseases.

Keywords: AL amyloidosis; electrophoresis; free light chains; immunofixation

References

  • 1.

    Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Inter., Suppl 2013;3:1–150.Google Scholar

  • 2.

    Rajkumar VS, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos MV, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 2014;15:538–48.Google Scholar

  • 3.

    Lovat LB, Persey MR, Madhoo S, Pepys MB, Hawkins PN. The liver in systemic amyloidosis: insights from serum amyloid P component scintigraphy in 484 patients. Gut 1998;42:727–34.Google Scholar

  • 4.

    Palladini G, Russo P, Bosoni T, Verga L, Sarais G, Lavatelli F, et al. Identification of amyloidogenic light chain requires the combination of serum-free light chain assay with immunofixation of serum and urine. Clin Chem 2009;55:499–504.Web of ScienceGoogle Scholar

  • 5.

    Katzmann JA, Kyle RA, Benson J, Larson DR, Snyder MR, Lust JA, et al. Screening panels for detection of monoclonal gammopathies. Clin Chem 2009;55:1517–22.Web of ScienceGoogle Scholar

  • 6.

    Bradwell AR, editor. Serum free light chain analysis plus Hevylite, 7th ed. Birmingham, UK: The Binding Site Group Ltd, 2015.Google Scholar

  • 7.

    Katzmann JA. Screening panels for monoclonal gammopathies: time to change. Clin Biochem Rev 2009;30:105–11.Google Scholar

  • 8.

    Nowrousian MR, Brandhorst D, Sammet C, Kellert M, Daniels R, Schuett P, et al. Serum free light chain analysis and urine immunofixation electrophoresis in patients with multiple myeloma. Clin Cancer Res 2005;11:8706–14.Google Scholar

  • 9.

    Coriu D, Weaver K, Schell M, Eulitz M, Murphy CL, Weiss DT, et al. A molecular basis for nonsecretory myeloma. Blood 2004;104:829–31.Google Scholar

  • 10.

    Attaelmannan M, Levinson SS. Understanding and identifying monoclonal gammopathies. Clin Chem 2000;46:1230–8.Google Scholar

  • 11.

    Tate J, Bazeley S, Sykes S, Mollee P. Quantitative serum free light chain assay – analytical issues. Clin Biochem Rev 2009;30:131–40.Google Scholar

  • 12.

    Kyle RA. Sequence of testing for monoclonal gammopathies. Arch Pathol Lab Med 1999;123:114–8.Google Scholar

  • 13.

    Sarav M, Wang Y, Hack BK, Chang A, Jensen M, Bao L, et al. Renal FcRn reclaims albumin but facilitates elimination of IgG. J Am Soc Nephrol 2009;20:1941–52.Google Scholar

  • 14.

    Holding S, Spradbery D, Hoole R, Wilmot R, Shields LM, Levoguer AM, et al. Use of serum free light chain analysis and urine protein electrophoresis for detection of monoclonal gammopathies. Clin Chem Lab Med 2011;49:83–8.Web of ScienceGoogle Scholar

  • 15.

    Graziani M, Merlini G, Petrini C. Guidelines for the analysis of Bence Jones protein. Clin Chem Lab Med 2003;41:338–46.Google Scholar

  • 16.

    Dispenzieri A, Kyle R, Merlini G, Miguel JS, Ludwig H, Hajek R, et al. International Myeloma Working Group guidelines for serum free light chain analysis in multiple myeloma and related disorders. Leukemia 2009;23:215–24.Web of ScienceGoogle Scholar

About the article

Corresponding author: Dr. Janka Franeková, Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague 14021, Czech Republic, E-mail: www.ikem.cz; and Third Faculty of Medicine, Charles University, Prague, Czech Republic


Received: 2015-08-24

Accepted: 2015-12-10

Published Online: 2016-01-13

Published in Print: 2016-06-01


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 54, Issue 6, Pages 981–984, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2015-0816.

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