聚合型 κ 轻链多发性骨髓瘤。

A Polymerized Kappa Light Chain Multiple Myeloma.

出版信息

Clin Lab. 2020 Dec 1;66(12). doi: 10.7754/Clin.Lab.2020.200339.

DOI:10.7754/Clin.Lab.2020.200339

PMID:33337841

Abstract

BACKGROUND

We report a case of a multiple myeloma with light polymerized kappa chains, a phenomenon rarely described.

METHODS

Capillary electrophoresis of serum proteins (Capillarys 2 Flex Piercing Sebia ®) revealed the presence of two migrant monoclonal peaks in the gamma globulin area and identified by immunosubtraction (IS) as light chain (LC) κ. These results suggest either the presence of a LCκ monoclonal IgD or IgE or the presence of a biclonal gammopathy or finally a LCκ polymerization. Serum immunofixation (IF) was carried out, after serum depolymerization with beta mercaptoethanol (BME), using as antiserum anti IgD, anti IgE and anti LCκ total and free LC κ. Capillary electrophoresis and IS were also repeated after serum treatment with BME.

RESULTS

The depolymerization of our patient's serum showed the transformation of the two serum peaks into a single peak at the level of the κ light chains on both capillary electrophoresis and immunotyping techniques (IF and IS).

CONCLUSIONS

Polymerization of kappa light chains is a rare phenomenon which can cause difficulty in the interpretation of the serum protein electrophoresis and immunotyping.

摘要

背景

我们报告了一例轻聚合 κ 链多发性骨髓瘤，这是一种很少被描述的现象。

方法

血清蛋白毛细管电泳（Capillarys 2 Flex Piercing Sebia ®）显示 γ 球蛋白区存在两种迁移的单克隆峰，并通过免疫吸收（IS）鉴定为 κ 轻链（LC）。这些结果提示存在 LCκ 单克隆 IgD 或 IgE，或者存在双克隆丙种球蛋白病，或者最终存在 LCκ 聚合。血清免疫固定电泳（IF）在使用 β-巯基乙醇（BME）对血清进行解聚后进行，使用抗 IgD、抗 IgE 和抗 LCκ 总 LCκ 和游离 LCκ 的抗血清进行。毛细管电泳和 IS 也在血清用 BME 处理后重复进行。