An unusual pattern in serum protein electrophoresis to take in mind: A case report

Gastélum-Cano, José María; Fragoso-Flores, Jaime; Noffal-Nuño, Víctor Manuel; Deffis-Court, Marcela

doi:10.1016/j.plabm.2020.e00200

Cited by 3 publications

(4 citation statements)

References 23 publications

(13 reference statements)

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“… 5 CE also provides better differentiation of the β region into β 1 - and β 2 -globulin fractions, thus improving further their separation. 5 6 Better resolution has been seen in CE when compared with agarose gel electrophoresis as it is based on the principle of endosmosis and also employs a high voltage (R) and which, in turns, facilitates separating the proteins into β 1 and β 2 fractions constituted majorly by globulin proteins transferrin, low-density lipoprotein, and complement proteins (C3,C4). The α1 fraction is majorly constituted by α1 antitrypsin and α1 acid glycoprotein (orosomucoid).…”

Section: Discussionmentioning

confidence: 99%

“…IS is performed using specific antisera against both heavy and light chains, and the IS occurred during the process of immunoelectrophoresis is identified and interpreted. 6 The specific antisera binds to its respective immunoglobulin if present in the sample, and the complex formed is precipitated and thus does not migrate, causing reduction or disappearance of peak as seen in CE. This reduction or disappearance of peak, characterizing a particular type, is appreciated when original capillary SPEP trace is overlayed on trace obtained by the addition of one of each five specific antisera to the patient's serum.…”

Section: Discussionmentioning

confidence: 99%

“…This reduction or disappearance of peak, characterizing a particular type, is appreciated when original capillary SPEP trace is overlayed on trace obtained by the addition of one of each five specific antisera to the patient's serum. 6 By this method, it is possible to recognize as well as quantify monoclonal proteins. Thus, capillary electrophoresis along with IS aids in the diagnosis and management of patients with MG.…”

Section: Discussionmentioning

confidence: 99%

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Unraveling the Possibilities of Monoclonal Protein Migration, Identification, and Characterization in SPEP on Capillary Zone Electrophoresis

et al. 2022

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Serum protein electrophoresis (SPEP) is a method by which proteins present in serum are separated into different fractions based on their molecular weight and electric charge. Presence of M spike, composed of monoclonal protein, on electrophoretogram is a characteristic finding that can be seen in monoclonal gammopathies like multiple myeloma. M spike is most commonly seen in the gamma region however, the M-spike can be observed in fraction other than the Y fraction as well i.e. in the beta region and rarely alpha region. Here we have enumerated few cases where M protein has been seen in fractions other than the gamma region. Thus one needs to be cautious about the variable appearance of M-spike during interpretation of SPEP as some physiological proteins if elevated can also give rise to similar spike sometimes referred as pseudo monoclonal pattern.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Unraveling the Possibilities of Monoclonal Protein Migration, Identification, and Characterization in SPEP on Capillary Zone Electrophoresis

et al. 2022

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“…When these conditions are not present, a monoclonal gammopathy is classified as of undetermined significance (MGUS). A MGUS is found in about 3-4% of the general population over the age of 50 (1) and can remain stable throughout life or evolve in 10% of cases within 5 years into a full-blown MM (2). The evidence of a double monoclonal band with characters of undetermined significance in protein electrophoresis is a very rare occurrence, which has never been described in a patient with systemic lupus erythematosus (SLE) associated with antiphospholipid syndrome (APS).…”

Section: N Introductionmentioning

confidence: 99%

Biclonal gammopathy of undetermined significance in a patient with systemic lupus erythematosus and antiphospholipid syndrome

2022

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The case of a patient suffering from systemic lupus erythematosus with associated antiphospholipid antibody syndrome is described. In this patient, on protein electrophoresis, two monoclonal immunoglobulin G λ and k peaks were seen, defining a condition of biclonal gammopathy of undetermined significance (BGUS). This condition is extremely rare, especially in chronic inflammatory rheumatic diseases. The criteria of a BGUS are defined. We also underline how this condition can be the expression of a concomitant unrecognized cancer, a possible amyloidosis or an infectious process.

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Case Report: Management of Primary Tracheobronchial Light Chain Amyloidosis in a Patient With Biclonal Gammopathy Using a Systemic Bortezomib-Based Regimen

Yan

Zhou

et al. 2021

Front. Med.

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Primary tracheobronchial light chain (AL) amyloidosis is a rare and heterogeneous disease characterized by the buildup of amyloid deposits in the airway mucosa. Although its treatment remains challenging, the current view is that the localized form can be treated conservatively due to its slow progression. While radiotherapy has proven effective in treating localized form of the disease, some patients do not respond to local treatment and continue to experience poor quality of life, highlighting the need to explore additional treatment strategies. In this report, we discuss a case of primary tracheobronchial AL amyloidosis with biclonal gammopathy (IgA κ and IgG κ) in a 46-year-old man who was transferred to our hospital due to dyspnea progression over the preceding 3 years. Chest computed tomography revealed irregular tracheobronchial stenosis with wall thickening, and histological examination of the bronchial biopsies confirmed the diagnosis of endobronchial AL amyloidosis. Owing to the poor effect of radiation therapy and treatments for improving airway patency, he was treated with a systemic chemotherapy regimen [cyclophosphamide-bortezomib-dexamethasone (CyBorD)]. We observed substantial improvements in his dyspnea, highlighting the potential of systemic therapy to improve quality of life of patients with tracheobronchial AL amyloidosis. However, the long-term pathological changes associated with local bronchial lesions require further investigation.

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An unusual pattern in serum protein electrophoresis to take in mind: A case report

Cited by 3 publications

References 23 publications

Unraveling the Possibilities of Monoclonal Protein Migration, Identification, and Characterization in SPEP on Capillary Zone Electrophoresis

Unraveling the Possibilities of Monoclonal Protein Migration, Identification, and Characterization in SPEP on Capillary Zone Electrophoresis

Biclonal gammopathy of undetermined significance in a patient with systemic lupus erythematosus and antiphospholipid syndrome

Case Report: Management of Primary Tracheobronchial Light Chain Amyloidosis in a Patient With Biclonal Gammopathy Using a Systemic Bortezomib-Based Regimen

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