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The serum free light-chain assay in combination with serum protein electrophoresis and serum immunofixation electrophoresis is sufficient to screen for pathological monoclonal plasmaproliferative disorders other than AL amyloidosis which requires all the serum tests as well as 24 h urine immunofixation electrophoresis.
Immunofixation tends to replace protein electrophoresis because : [citation needed] it is faster (results within three hours); it is somewhat more sensitive. Immunofixation may reveal an immunoglobulin missed out by protein electrophoresis, especially at low concentrations (less than 1 gram/litre);
Serum protein electrophoresis or immunofixation is positive in 67-100% of cases, while urine protein electrophoresis or immunofixation is positive in 50-100% of cases. [2] Serum free light chain measurement is positive in 100% of cases, evidence that the underlying monoclonal plasma cells secrete free light chains as well as heavy chains.
type 3, oligoclonal bands in CSF and serum with additional bands in CSF; type 4, identical oligoclonal bands in CSF and serum, type 5, monoclonal bands in CSF and serum, type 6, presence of a single band limited to the CSF. Type 2 and 3 indicate intrathecal synthesis, and the rest are considered as negative results (No MS).
The prevalence and incidence of MGRS in the general population or in specific populations is not known but it is more prevalent in those over the age of 50 as there is a monoclonal protein (M-protein) present in 3% of those 50 and years older and 5% of those 70 years and older (the presence of MGUS), placing those 50 and older at increased risk ...
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More recently, serum free light chain assays have been utilised in a number of published studies which have indicated superiority over the urine tests, particularly for patients producing low levels of monoclonal free light chains, as seen in nonsecretory multiple myeloma [5] [6] [7] and amyloid light chain amyloidosis (AL amyloidosis). [7] [8 ...
Immunoelectrophoresis and immunofixation studies help identify the type of immunoglobulin, the light chain's clonality, and the paraprotein's monoclonality and quantitation. High-resolution electrophoresis and serum and urine immunofixation are recommended to help identify and characterize the monoclonal IgM paraprotein.