title: [A case with multiple myeloma in which serum forms gel precipitation upon exposure to air].
abstract: We present the case of a 69-years-old man who was admitted to hospital with multiple myeloma. IgG-kappa type monoclonal protein was detected in the serum. When we separated the serum obtained from blood sample of the patient and the lid of the collecting tube was opened, the patient's serum became gelled immediately. When the lid of the collecting tube remained closed, the patient's serum did not become gelled even at 4 degrees C. Moreover, the gelled serum of the patient did not resolve at 56 degrees C. Taken together, these results indicated that gel formation of the patient's serum may not be due to cryoglobulin. It was found that the pH of the patient's serum elevated to pH 8.0 quickly after exposed to air. It was also found that the patient's serum, but not the sera of other IgG-kappa multiple myeloma patients, became gelled as soon as PBS of pH 8.0 was added. These results highly suggest that the patient's serum becomes gelled at pH 8.0. However, the isoelectric focusing of isolated precipitation in the patient showed fractions around the pH 8.5-8.7 zone, which was different from the pH at which the precipitation began to form. We think that this may be the first report of a multiple myeloma patient whose serum becomes gelled after exposed to air.
authors.affiliation: Department of Clinical Laboratory, Kobe City General Hospital, Kobe 650-0046.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Oita
authors.forename: Akiko
authors.initials: A
authors.lastname: Yamashiro
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakizono
authors.forename: Masaaki
authors.initials: M
authors.lastname: Etoh
authors.forename: Fumiko
authors.initials: F
authors.lastname: Mizutani
authors.forename: Shuuji
authors.initials: S
authors.lastname: Imoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nagai
authors.forename: Shinpei
authors.initials: S
authors.lastname: Kasakura
mesh_terms: D000368:Aged; D000388:Air; D011232:Chemical Precipitation; D005782:Gels; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007074:Immunoglobulin G / Q000302:isolation & purification; D007145:Immunoglobulin kappa-Chains / Q000302:isolation & purification; D007525:Isoelectric Focusing; D008297:Male; D009101:Multiple Myeloma / Q000097:blood* / Q000175:diagnosis; D009194:Myeloma Proteins / Q000302:isolation & purification
chemical_list: D005782:Gels; D007074:Immunoglobulin G; D007145:Immunoglobulin kappa-Chains; D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins