Lambda light chain myeloma with co-migrating paraprotein at beta region on agarose gel electrophoresis: A case report

M. Siti Sarah, Umar Nor Aini, Nurismah Md Isa, Hafiza Alauddin, Khalidah Adibah Mazlan, A. B. Mokhtar, Srijit Das

Research output: Contribution to journalArticle

Abstract

Paraproteinemia is one of the diagnostic features of multiple myeloma. A commonly used method is the detection of paraprotein by agarose gel electrophoresis (AGE) followed by by immunofixation electrophoresis (IFE) to confirm monoclonality. Due to their smaller size, immunoglobulin A (IgA) and light chain only paraproteins may appear at the beta or even alpha 2 protein fractions. Here, we discuss a case report of a 47-year-old man who presented with pathological fracture of third thoracic (T3) vertebra. Serum protein electrophoresis (SPE) was initially reported as no paraprotein detected. However, a bone biopsy was reported to show plasma cell proliferation with light chain restriction. A repeat sample for protein electrophoresis together with IFE revealed lambda light chain paraprotein co-migrating at the beta region. The beta band plus paraprotein was quantitated as 4.3 g/L (7.0%), which was within normal limits of the beta protein fraction. Hence, it has to be remembered that if the SPE is negative, it does not necessarily mean that the paraprotein is absent in cases which are highly suspicious.

Original languageEnglish
Pages (from-to)35-39
Number of pages5
JournalClinica Terapeutica
Volume165
Issue number1
DOIs
Publication statusPublished - 2014

Fingerprint

Paraproteins
Agar Gel Electrophoresis
Electrophoresis
Light
Blood Proteins
Thoracic Vertebrae
Immunoglobulin Light Chains
Spontaneous Fractures
Paraproteinemias
Proteins
Plasma Cells
Multiple Myeloma
Immunoglobulin A
Cell Proliferation
Biopsy
Bone and Bones

Keywords

  • Agarose gel
  • Immunofi xation electrophoresis
  • Light chain
  • Multiple myeloma
  • Paraprotein

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Lambda light chain myeloma with co-migrating paraprotein at beta region on agarose gel electrophoresis: A case report",
abstract = "Paraproteinemia is one of the diagnostic features of multiple myeloma. A commonly used method is the detection of paraprotein by agarose gel electrophoresis (AGE) followed by by immunofixation electrophoresis (IFE) to confirm monoclonality. Due to their smaller size, immunoglobulin A (IgA) and light chain only paraproteins may appear at the beta or even alpha 2 protein fractions. Here, we discuss a case report of a 47-year-old man who presented with pathological fracture of third thoracic (T3) vertebra. Serum protein electrophoresis (SPE) was initially reported as no paraprotein detected. However, a bone biopsy was reported to show plasma cell proliferation with light chain restriction. A repeat sample for protein electrophoresis together with IFE revealed lambda light chain paraprotein co-migrating at the beta region. The beta band plus paraprotein was quantitated as 4.3 g/L (7.0{\%}), which was within normal limits of the beta protein fraction. Hence, it has to be remembered that if the SPE is negative, it does not necessarily mean that the paraprotein is absent in cases which are highly suspicious.",
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AU - Md Isa, Nurismah

AU - Alauddin, Hafiza

AU - Mazlan, Khalidah Adibah

AU - Mokhtar, A. B.

AU - Das, Srijit

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AB - Paraproteinemia is one of the diagnostic features of multiple myeloma. A commonly used method is the detection of paraprotein by agarose gel electrophoresis (AGE) followed by by immunofixation electrophoresis (IFE) to confirm monoclonality. Due to their smaller size, immunoglobulin A (IgA) and light chain only paraproteins may appear at the beta or even alpha 2 protein fractions. Here, we discuss a case report of a 47-year-old man who presented with pathological fracture of third thoracic (T3) vertebra. Serum protein electrophoresis (SPE) was initially reported as no paraprotein detected. However, a bone biopsy was reported to show plasma cell proliferation with light chain restriction. A repeat sample for protein electrophoresis together with IFE revealed lambda light chain paraprotein co-migrating at the beta region. The beta band plus paraprotein was quantitated as 4.3 g/L (7.0%), which was within normal limits of the beta protein fraction. Hence, it has to be remembered that if the SPE is negative, it does not necessarily mean that the paraprotein is absent in cases which are highly suspicious.

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