Identification of monoclonal gammopathies: a comparison of immunofixation, immunoelectrophoresis and measurements of kappa- and lambda-immunoglobulin levels

We study whether immunoelectrophoresis (IE) could be replaced by immunofixation (IF) for the routine diagnosis of monoclonal gammopathies and/or by a quantitative measurement of kappa-resp. lambda-Ig levels in serum. The values of these measurements, together with the level of each Ig class, were us...

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Bibliographic Details
Published inJournal of clinical & laboratory immunology Vol. 26; no. 3; p. 141
Main Authors Duc, J, Morel, B, Peitrequin, R, Frei, P C
Format Journal Article
LanguageEnglish
Published Scotland 01.07.1988
Subjects
Diagnostic Errors
Evaluation Studies as Topic
Humans
Hypergammaglobulinemia - diagnosis
Hypergammaglobulinemia - immunology
Immunoelectrophoresis
Immunoglobulin kappa-Chains - analysis
Immunoglobulin lambda-Chains - analysis
Immunologic Tests
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Summary:We study whether immunoelectrophoresis (IE) could be replaced by immunofixation (IF) for the routine diagnosis of monoclonal gammopathies and/or by a quantitative measurement of kappa-resp. lambda-Ig levels in serum. The values of these measurements, together with the level of each Ig class, were used to calculate two ratios. IF, IE and calculation of both ratios were simultaneously applied to 153 serum samples. A monoclonal gammopathy (MGP) was found with all three methods in 51 cases and by none of them in another 51 cases. The first two techniques were positive and the third one negative in 16 cases. In 15 cases, IF showed the presence of a MGP, which was not or incompletely identified with IE, these results being associated with normal (7x) or abnormal ratios (8x). Nineteen cases with normal IF and IE had one or two abnormal ratios. After comparison with clinical data and outcome, we conclude that IF revealed 15 cases of MGP, which were not or only partially shown by IE. IE did not show any case of MGP not detected by IF. One of the ratios appeared as an interesting adjunct to the diagnostic procedure, but insufficient to be used as a single test. The other appeared to be of no diagnostic help. We conclude that immunofixation is the test of choice in the routine diagnosis of monoclonal gammopathies.
ISSN:0141-2760