Danalakshmi S
Department of Biochemistry, Apollo hospitals, Chennai, Tamil Nadu, India.
EJIFCC. 2023 Oct 16;34(3):250-257. eCollection 2023 Oct.
Multiple myeloma (MM) is a neoplasm characterized by malignant proliferation of plasma cells that produce excessive quantities of a single type of immunoglobulin (Ig) called as monoclonal immunoglobulin or M-protein or paraprotein. M-protein produced can be either an intact antibody with both heavy and light-chain components or only light chains or rarely only heavy chains. Presence of M-protein in serum protein electrophoresis (PEP) is useful in the diagnosis, prognosis, and treatment of MM and other plasma cell dyscrasias. These M-proteins are identified commonly in beta and gamma regions and very rarely in alpha 2 region, appearing as a narrow band in agarose electrophoresis or as a sharp symmetric spike (M-spike) or peak in capillary zone electrophoresis. Here, we present an unusual case of monoclonal light chains producing two M- spikes in the alpha 2 globulin region in capillary zone electrophoresis.
多发性骨髓瘤(MM)是一种以浆细胞恶性增殖为特征的肿瘤,这些浆细胞会产生过量的单一类型免疫球蛋白(Ig),称为单克隆免疫球蛋白或M蛋白或副蛋白。产生的M蛋白可以是同时具有重链和轻链成分的完整抗体,或者只是轻链,极少数情况下只是重链。血清蛋白电泳(PEP)中M蛋白的存在对MM和其他浆细胞发育异常的诊断、预后及治疗具有重要意义。这些M蛋白通常在β和γ区被识别,很少出现在α2区,在琼脂糖电泳中表现为一条窄带,在毛细管区电泳中则表现为尖锐的对称峰(M峰)。在此,我们报告一例罕见病例,该病例中的单克隆轻链在毛细管区电泳的α2球蛋白区产生了两个M峰。