Restricted electrophoretic heterogeneity of immunoglobulin light chains in urine: a cause for confusion with Bence Jones protein.
نویسندگان
چکیده
The detection of Bence Jones protein, an important part of the investigation of suspected myeloma, is most commonly done by agarose or cellulose nitrate electrophoresis followed by immunofixation. Bence Jones protein is recognized as single or multiple bands of one type of light chain. Unfortunately, improvements in sensitivity of these techniques (use of high-affinity antisera and higher resolution electrophoresis) frequently allow detection of multiple light chain bands in the urine of patients who do not have a B-cell dyscrasia. The bands are usually kappa, although they may be accompanied by lambda bands. This pattern may lead to the misdiagnosis of Bence Jones protein and oligoclonal light chain production in patients. Here we show that this pattern is produced by polyclonal light chains; it is present in the urine of all patients with a tubular proteinuria of any etiology and may be induced in healthy individuals by blocking their renal tubular protein reabsorption. Polyclonal light chains separate into monomers and dimers on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and into four major bands with many minor bands by isoelectric focusing. This difference in charge and possibly size results in the banding pattern seen on good-quality electrophoresis and immunofixation.
منابع مشابه
Alan Solomon and Carla
The immunochemical demonstration that the Bence Jones protein from the urine of an individual patient with multiple myeloma was antigenically identical to a portion of the homologous serum myeloma protein (1), and the establishment of the chemical and structural similarities between Benee Jones proteins and light polypeptide chains (2, 3) which are common to immunoglobulins of all known classes...
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Deposition of immunoglobulin light chains is a result of clonal proliferation of monoclonal plasma cells that secrete free immunoglobulin light chains, also called Bence Jones proteins (BJP). These BJP are present in circulation in large amounts and excreted in urine in various light chain diseases such as light chain amyloidosis (AL), light chain deposition disease (LCDD) and multiple myeloma ...
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Bence-Jones proteinuria refers to urinary excretion of monoclonal light chains. It results from exclusive production of one light chain, or the unbalanced synthesis of heavy and light chains, with the latter being in excess. Free Kor A-light chains are therefore excreted alone or in addition to complete immunoglobulin molecules carrying the same light chain type. Free light chains are low molec...
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The basic immunoglobulin subunit consists of two heavy and two light chains held together by covalent disulphide bonds. In most cases of myeloma and Waldenstrom's disease there is an excess synthesis of light over heavy chains, resulting in Bence Jones proteinaemia and proteinuria. Furthermore, in some cases ("light chain disease"), there is absence of detectable heavy chain synthesis, and the ...
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ورودعنوان ژورنال:
- Clinical chemistry
دوره 37 9 شماره
صفحات -
تاریخ انتشار 1991