ISSN:
1398-9995
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Over a period of 5 years, an isolated light chain ‘K = 9, λ= 12) was detected in 21 sera by immunofixation electrophoresis. Further analysis with anti-δ- and anti-ɛ-specific antisera identified four δ heavy chains, all associated with a λ light chain, and no ɛ heavy chains. For evaluation of the role of two-dimensional polyacrylamide gel electrophoresis ‘2D-PAGE) in the diagnosis of IgD paraproteins, as a possible alternative or complement to immunofixation, IgD paraproteins were retrospectively analyzed by 2D-PAGE. δ Heavy chains migrated to gel areas clearly distinguishable from other heavy chains α, γ, or μ, and in a wide range of isoelectric points ‘pl: 5.4-8). In one serum, the monoclonal δ chain had a pi range comparable to that of albumin and was undetectable. However, all four δ chains were easily identified when analyzed from affinity-purified immunoglobulin fractions. These observations showed the following:1) IgD paraproteins are not rare among apparently isolated monoclonal light chains detected by routine immunofixation, Ostrongly confirming the need for further analysis with anti-δ antisera, before assumption of a light-chain disease.2) 2D-PAGE analysis of affinity-purified immunoglobulin fractions allowed correct identification of IgD monoclonal gammopathies in all cases.3) However, although 2D-PAGE analysis is now easy to perform, well standardized, and highly sensitive, this technique remains time-consuming and expensive, and does not appear suitable for routine practice as a first-line diagnostic procedure.2D-PAGE should find its place as a complement to immunofixation and in the definitive demonstration, in selected ambiguous cases, of the clonal pattern of a suspected gammopathy at immunofixation.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1111/j.1398-9995.1995.tb02583.x
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