Articles / Investigation of Paraproteinaemia
writer
Head of the Immunology Department at Sullivan Nicolaides Pathology; Chair of Sullivan Nicolaides Pathology Partners.
Paraproteins are abnormal monoclonal immunoglobulins produced in plasma cell disorders (eg multiple myeloma), lymphoproliferative disorders (eg CLL, Waldenstrom’s macroglobulinaemia) and in some infections (hepatitis C).
The introduction of the assay, serum free light chains (FLC) has meant the initial investigation of paraproteinaemia has become much simpler.
Previously, serum tests had great difficulty in detecting immunoglobulin light chains for two reasons:
1. Light chains are rapidly cleared by the kidneys, up until a certain point where they ‘spilled’ over into the blood.
2. Assays had poor sensitivity in detecting ‘free’ light chains ie light chains not bound to heavy chains as in normal immunoglobulin.
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writer
Head of the Immunology Department at Sullivan Nicolaides Pathology; Chair of Sullivan Nicolaides Pathology Partners.
Yes, for a majority of junior doctors
Yes, for about half of junior doctors
Yes, for a minority of junior doctors
No, not that I have observed
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