Gamma heavy chain disease screening showing a discrepancy between electrophoretic and nephelometric determinations of serum gamma globulin concentration.
A 75-year-old woman with rheumatoid arthritis showed a discrepancy between the reduced level of serum gamma globulin on cellulose acetate electrophoresis and the normal level of serum IgG determined by laser nephelometry. Although no M-peak was detectable on cellulose acetate electrophoresis, immunoelectrophoresis of the patient's serum revealed a monoclonal protein reacting with anti-IgG antiserum but not with anti-kappa or anti-lambda light chain antiserum. Western blotting of the patient's serum showed abnormal low-molecular-weight gamma chains. Thus, the patient was diagnosed with gamma heavy chain disease. A comparison of gamma globulin levels determined by different methods may be useful when screening for this disease.
Takatani
Tsunenori
T
Central Clinical Laboratory, Nara Medical University Hospital, Nara Medical University, Shijo-Cho 840, Kashihara, Nara 634-8522 Japan.
Morita
Keiko
K
Takaoka
Naomi
N
Tatsumi
Masatsuga
M
Okuno
Yorio
Y
Masutani
Takayuki
T
Murakawa
Koichi
K
Fukui
Akihiro
A
Tsukaguchi
Nobuhiko
N
Okamoto
Yasuyuki
Y
D000368:Aged; D015153:Blotting, Western; D003951:Diagnostic Errors; D004588:Electrophoresis, Cellulose Acetate; D005260:Female; D006362:Heavy Chain Disease / Q000097:blood* / Q000175:diagnosis*; D006801:Humans; D007122:Immunoelectrophoresis; D007074:Immunoglobulin G / Q000097:blood; D008403:Mass Screening; D009391:Nephelometry and Turbidimetry; D013223:Statistics as Topic; D005719:gamma-Globulins / Q000032:analysis*
D007074:Immunoglobulin G; D005719:gamma-Globulins