Screening for M-proteinemia: serum protein electrophoresis and free light chains compared

Abstract

Background: The objective of this study was to evaluate the efficiency of free light chain (FLC) analysis in comparison to serum protein electrophoresis (SPE) for detecting M-proteinemia. Methods: A total of 553 consecutive patients for whom evaluation of M-proteinemia was requested were included in this study. For all patients, serum FLC analysis and SPE followed by pentavalent immunofixation analysis was performed. Identification of monoclonal bands was performed using specific antisera. FLC analysis was performed using the Modular P analyzer in accordance with the manufacturer's recommendations. Local reference ranges for FLCs on this platform were established based on samples from patients with a normal electrophoretic pattern wno monoclonal bands, no hypo-or hypergammaglobulinemia, no acute phase pattern and normal kidney function, i.e., estimated glomerular filtration rate (eGFR) )60 mL/minx. Results

Comparision of the diagnostic sensitivity of biochemical tests in the screening of monoclonal gammopathy

“…6 SPE is the first choice of test for the screening of monoclonal gammopathy. The sensitivity of SPE alone in identifying monoclonal gammopathy was found to be 74% from a study by Mayo group, 8 while it was 94% and 90% by Mc Taggart et al 3 and Bakker et al 9 respectively. In our study, the sensitivity is 84%.…”

Detection and quantification of M-proteinemia: comparison of various methods for serum protein electrophoresis

“…To overcome this problem, it is recommended to use pentavalent immunofi xation analysis when no visible monoclonal bands are detected in SPE (4,5,8) . In previous investigations on more than 500 patients screened for M-proteinemia, we missed two patients ( < 1 % ) because the M-protein was hidden in the β -zone (9,10) . Using CE as a screening technique overlooking of M-proteins occurred in about 2 % of the patients (10) .…”