Strengths and weaknesses of methods for identifying monoclonal free light chains of Ig: examples from two cases with renal disease

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Abstract

Background:

Serum free light chain (FLC) analysis with ratio and urine immunofixation electrophoresis (IFE) are both available for routine use in helping to detect plasma cell dyscrasia and related diseases.

Cases:

Case reports showing one serum positive for serum FLC but that showed a hook effect and overestimated the amount of monoclonal FLC while urine IFE was negative for Bence Jones protein, and a second serum that showed elevated FLC κ and λ but a normal κ/λ ratio, while urine IFE was positive for Bence Jones protein.

Conclusions:

These two techniques complement one another. Neither of the techniques is truly quantitative, and both exhibit methodological defects.

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