Urinary beta2-microglobulin masquerading as a Bence Jones protein.
Bence Jones proteinuria, a common clinical manifestation of multiple myeloma, can also be seen in patients with other B-cell-derived neoplasms. Measurement of pretreatment levels is a useful adjunct in the diagnosis and staging of multiple myeloma, whereas serial levels reflect response to therapy. Serum concentrations of beta2-microglobulin, a small-molecular-weight protein associated with the major histocompatibility complex class I antigens, are often elevated in hematopoietic neoplasms and are also commonly measured at baseline, before treatment, and serially throughout therapy in patients with multiple myeloma and other lymphoproliferative disorders as a marker of tumor burden. Urinary concentrations, however, are considered an indicator of renal tubular function. High urinary levels are found in tubular proteinuria, a frequent sequela of long-standing multiple myeloma. A case is described in which a high urinary concentration of beta2-microglobulin interfered with Bence Jones protein quantification by electrophoresis studies.
Department of Laboratory Medicine, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA. bhandy@mdanderson.org
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D051792:Basic Helix-Loop-Helix Proteins; D001536:Bence Jones Protein / Q000652:urine*; D004268:DNA-Binding Proteins / Q000652:urine*; D003937:Diagnosis, Differential; D006801:Humans; D007122:Immunoelectrophoresis; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000652:urine; D015534:Trans-Activators / Q000652:urine*
D051792:Basic Helix-Loop-Helix Proteins; D001536:Bence Jones Protein; D004268:DNA-Binding Proteins; D015534:Trans-Activators; C093970:NEUROD1 protein, human