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Urine immunofixation electrophoresis remains important and is complementary to serum free light chain
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Stanley S. Levinson
Veröffentlicht/Copyright:
13. Juni 2011
Abstract
Articles have debated whether or not urine analysis remains valuable for identifying monoclonal gammopathies. A general impression is that the newer serum free light chain (FLC) assay is more analytically sensitive, more quantitative and simpler to perform. Many laboratory directors may have seized on the idea of eliminating urine analysis because it is a tedious procedure and requires expert interpretation while most laboratories can perform automated serum FLC assay. Others have concluded that urine immunofixation electrophoresis (IFE) optimizes the diagnostic sensitivity and should be included when there is a clinical indication. Here, I show that papers faulting urine analysis often used inappropriate urine methodology and this helps explain why there was misinterpretation. Moreover, the literature, shows urine IFE is often more sensitive for identifying low-level monoclonal FLC than the serum assay because urine IFE is as sensitive when performed appropriately and generally more specific. Besides, the reference range for serum FLC assay is unclear which is a great problem in assessing response to treatment and in identifying diseases when there is low concentration monoclonal FLC. I conclude that urine IFE remains important and is complementary to serum FLC assay, although the best algorithms for use remains to be elucidated.
Keywords: analytical sensitivity; immunofixation electrophoresis; methodological imperfection; serum free light chain assay; urine protein electrophoresis
Received: 2011-4-1
Accepted: 2011-5-10
Published Online: 2011-06-13
Published in Print: 2011-11-01
©2011 by Walter de Gruyter Berlin Boston
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Schlagwörter für diesen Artikel
analytical sensitivity;
immunofixation electrophoresis;
methodological imperfection;
serum free light chain assay;
urine protein electrophoresis
Artikel in diesem Heft
- Editorial
- Thank you, indeed!
- Reviews
- Glomerular filtration rate estimation: performance of serum cystatin C-based prediction equations
- Oxidative stress and diabetes mellitus
- Human papilloma virus (HPV) molecular diagnostics
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- General Clinical Chemistry and Laboratory Medicine
- The value of serum ischemia-modified albumin for assessing liver function in patients with chronic liver disease
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