[Immunological diagnosis of light chain disease--analysis of 11 cases found in Fujian Province].
This paper reports 11 cases of light chain disease (LCD) sequentially found in several coastal cities of Fujian Province. Immunological classification of this group of LCD was as follows: 6 belonged to lambda type, 4 were kappa type, and 1 was double LCD. We found that LCD was common in Fujian next only to MM of IgG class and accounted for 20% of the total 55 MM cases found in recent years. Several important points should be stressed when making immunological diagnosis of LCD. 1) It is well known that in most patients with LCD, M protein or Bence Jones proteinemia (BJPemia) is not detectable by conventional electrophoresis. Our studies show that running serum protein along with urinary BJP on the same one gel plate can allow for the recognition of small and faint band (s) of free light chain in serum, and also provides a rapid and sensitive method (immunofixation) to directly detect urinary light chains. 2) The concurrent presence of albumin with BJP in urine may interfere with the routine BJP test and lead to misdiagnosis. 3) As a result of the molecular seiving effect, the presence of light chain polymers in high BJP urine may lead to the presence of several parallel bands on the BJP gel electrophoretic spectrum, 4) Determination of light chain in urine is essential for final immunological diagnosis of LCD, but care should be taken, since many patients with other immunological types of MM may have a positive BJP test.
Qiu
W
W
Fujian Medical College, Fuzhou.
Wu
G
G
D001536:Bence Jones Protein / Q000652:urine; D006801:Humans; D006942:Hypergammaglobulinemia / Q000175:diagnosis*; D007145:Immunoglobulin kappa-Chains / Q000032:analysis; D007146:Immunoglobulin lambda-Chains / Q000032:analysis; D007159:Immunologic Tests; D009101:Multiple Myeloma / Q000175:diagnosis*
D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains; D001536:Bence Jones Protein