title: Combined light chain immunofixation to detect monoclonal gammopathy: a comparison to standard electrophoresis in serum and urine.
abstract: BACKGROUND
  The purpose of this study was to evaluate a combined κ and λ light chain immunofixation (CLIF) as a screening tool to detect monoclonal immunoglobulins in serum and urine. A secondary aim was to investigate the impact on workflow and reagent utilisation of a systematic implementation of CLIF in addition to routine protein electrophoresis (PE) on all samples.
  
  
  METHODS
  Light chain antisera (κ and λ) were mixed in a 1:1 ratio and loaded in the same sequence as the PE to create a superimposable image.
  
  
  RESULTS
  The CLIF procedure agreed significantly better with standard immunofixation procedures in the serum and urine. In 33 (22%) new patients and in 114 (15%) follow-up patients CLIF detected a band missed by PE in serum. In 34 (4.5%) of previously categorised cases the monoclonal band was below the detection limit of CLIF in serum, but still detectable by conventional immunofixation electrophoresis. In one case (0.7%) a band in a urine specimen was missed by CLIF compared to 70 (49%) missed by PE. After the systematic introduction of CLIF turn-around-times (TATs) and utilisation of laboratory consumables decreased significantly (p<0.001).
  
  
  CONCLUSIONS
  A systematic implementation of CLIF led to the detection of monoclonal bands missed by PE with an improvement in TATs and a decrease in cost.
authors.forename: Wessel
authors.initials: W
authors.lastname: Jenner
authors.forename: Sandra
authors.initials: S
authors.lastname: Klingberg
authors.forename: Jill R
authors.initials: JR
authors.lastname: Tate
authors.forename: Urs
authors.initials: U
authors.lastname: Wilgen
authors.forename: Jacobus P J
authors.initials: JP
authors.lastname: Ungerer
authors.forename: Carel J
authors.initials: CJ
authors.lastname: Pretorius
mesh_terms: D001797:Blood Protein Electrophoresis; D005260:Female; D006801:Humans; D007122:Immunoelectrophoresis; D007145:Immunoglobulin kappa-Chains / Q000097:blood* / Q000652:urine*; D007146:Immunoglobulin lambda-Chains / Q000097:blood* / Q000652:urine*; D008297:Male; D010265:Paraproteinemias / Q000097:blood / Q000175:diagnosis* / Q000652:urine
chemical_list: D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains