Background: Serum free light chain analysis is now well established in the investigation of monoclonal gammopathies. In the UK there has, until recently, been a single supplier of kits for such analysis. Recently, a second method using monoclonal antisera was introduced. We have compared the performance of these two kits in four routine laboratories. Method: Samples submitted for routine analysis (327 samples, 258 [79%] from patients with B-cell lymphoproliferative disease) for serum free light chains were tested by both technologies (Freelite, Binding Site and N Latex FLC, Siemens), according to the manufacturers' instructions. Results: Qualitative data were available by both methods on 313 samples for serum free kappa chains and 324 samples for lambda free light chains. We found poor correspondence of 81% for kappa and 74% for lambda. Five percent of samples were significantly discordant in these assays. Conclusions: These assays perform very differently in clinical practice. They cannot be used interchangeably, especially if monitoring patient responses to therapy.

The transformation of the antineutrophil cytoplasmic antibody (ANCA) specificity in the absence of specific drug treatment has not been reported in the literature. A few studies have suggested changes in the epitopes recognized by the ANCAs. We describe two patients who switched from myeloperoxidase-positive to PR3 ( proteinase 3)-positive ANCA during the course of their disease process and subsequently remained unchanged. One patient developed ulcerative colitis following the appearance of PR3-ANCA while the other remains quiescent. Regular follow-up and close monitoring of ANCA specificity are essential. A change of specificity may indicate the development of a new ANCA-related disease.

SummaryThe clinical utility of molecular diagnostic approaches in allergy investigation is increasingly being recognized to play a significant role in the management of allergic patients. Determining the sensitisation pattern, which is best achieved through the use of component resolved diagnostics (CRD), allows effective risk stratification, appropriate treatment and patient selection for immunotherapy.In order to assess the diagnostic service provisions for in vitro allergy testing across Europe, a survey was carried out via the total IgE and Specific IgE external quality assurance schemes run by UK NEQAS Immunology, Immunochemistry & Allergy.This survey assessed allergy testing and in particular allergen-components offered by the laboratories and found a wide variability in service provision, particularly between the UK and EU. Furthermore, there was lack of standardisation for acquisition of clinical information to aid allergen (and component) selection, gating strategy, testing algorithms and clinical interpretation. Interestingly, a significant proportion of laboratories (the majority from EU) stated that they 'used' the results for peanut components for risk stratification. However, vast majority of participants were unaware of guidelines relating to the use of allergen component testing and agreed further education would assist in reaching a common platform.

Tomato pomace, a by-product of tomato juice industry, is a rich source of fibre and polyphenols. Also in view of the antioxidant property of pomace, it would play an important role in prevention of diseases. Tomato pomace procured from Food processing training centre (FPTC) SKUAST-K, Shalimar, contained 87.20% moisture, 1.10% ash and 6.20% of dietary fibre. Finely ground tomato pomace was incorporated in wheat flour at 5%, 10%, 15 %, 20% and 25% levels for development of cookies. Water absorption increased significantly from 58.20% to 67.30% with increase in pomace from 0% to 25%. Dough stability decreased and mixing tolerance index increased, indicating weakening of the dough. Resistance to extension values significantly increased from 330 to 625 BU whereas extensibility values decreased from 120 to 42 mm. Cookie were prepared from blends of wheat flour containing 0-25% tomato pomace. The diameter and spread factor of cookies increased from 53.25 to 53.80 mm and 77.1 to 81.02, respectively with increase in pomace content from 0% to 25%. The thickness of cookies decreased with increase in pomace levels. Volume of cookies decreased with incorporation of tomato pomace. Cookies prepared from 25% of tomato pomace had dietary fibre and total phenol content content of 10.23% and 6.20 mg GAE/100g as compared to control indicating that tomato pomace can serve as a good source of both polyphenols and dietary fibre.

Background: In a small, but potentially significant proportion of patients with a monoclonal gammopathy, patients show the existence of an intact monoclonal (M-) protein co-migrating with a free light chain (FLC) M-protein. Using traditional methods for detection of monoclonal immunoglobulins, only the intact M-protein may be detectable, and hence the FLC M-proteins may be missed. Methods: Immunofixation electrophoresis (IFE) using two different sets of antisera were compared (one detecting both free and bound FLC epitopes, and one detecting only the free FLC epitopes), alongside urine protein electrophoresis and the Freelite assay in order to ascertain the best methods of detecting both types of M-proteins in this subset of patients. Results: A total of 2% of the patient population tested were shown to have a FLC M-protein migrating coincidentally with an intact M-protein. These were not detected by IFE using the widely utilised antisera to both free and bound FLC epitopes, and hence may have been missed during routine testing, but were detectable using the other methods. Conclusions: This study highlights the important finding that in some patients with both an intact and a FLC M-protein, the FLC M-protein may be missed during routine testing. In incidences where no corresponding urine sample is sent to the laboratory alongside the serum sample, we would suggest testing for the presence of FLC M-proteins in this subset of patients using the Freelite assay, if no urine sample can be obtained, to ensure all FLC M-proteins are appropriately detected.