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Clin Chem Lab Med. 2014 May;52(5):665-9. doi: 10.1515/cclm-2013-0714.

Analysis of patients with γ-heavy chain disease by the heavy/light chain and free light chain assays.

Abstract

BACKGROUND:

The objective of this study was to evaluate the performance of the heavy/light chain and free light chain immunoassays in patients with heavy chain disease, and to assess the ability of the heavy/light chain assay to measure and confirm the abnormal, truncated heavy chain.

METHODS:

Frozen serum samples from 15 γ-heavy chain disease patients were tested for IgGκ, IgGλ, total IgG, free light chains, and M-spike concentrations.

RESULTS:

The (Gκ+Gλ)/IgGtotal ratio for these 15 patients ranged from 0.02 to 0.80. The 10 patients with IgG concentrations above 1 g/dL all had ratios below 0.3 indicating that a substantial portion of IgG was not quantitated by the Gκ and Gλ reagents. The average M-spike was 1.61 g/dL and the average calculated abnormal γ-chain concentration was 2.94 g/dL. Additionally, free light chain analysis revealed the presence of monoclonal free κ light chain in three of the 15 patients.

CONCLUSIONS:

This study demonstrates utility of a nephelometric assay to identify truncated immunoglobulin heavy chains in γ-HCD and that 20% of these patients also have monoclonal free light chain.

PMID:
24327529
DOI:
10.1515/cclm-2013-0714
[Indexed for MEDLINE]

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