A Case of Multiple Myeloma with Biclonal (IgG-K and IgA-K) M-proteins / 대한임상병리학회지

Two M-protein peaks in serum protein electrophoresis are rarely present in patients with plasma cell discrasia. We describe a 72-year-old male patient with multiple myeloma secreting biclonal M-proteins, which were confirmed by immunofixation. Immunoelectrophoresis has some difficulties to dectect M components when a very small amount of M-protein develops an equivocally abnormal precipitation arc. In this case, serum protein electrophoresis revealed two M peaks, one in beta and the other in gamma globulin region. An immunoelectrophoresis revealed unequivocally abnormal precipitation arcs in IgA and K light chain regions, but the arc in IgG region was equivocal. We performed an immunofixation and confirmed biclonal gammopathy, IgA-K and IgG-K types. This result supports the view that immunofixation is an useful confirmatory test when immunoelectrophoresis results are equivocal.

A Case of Lactate Dehydrogenase-IgGk, lambda Complex in Angioimmunoblastic Lymphadenopathy with Dysproteinemia / 대한임상병리학회지

There are various complex formations between immunoglobulin and serum enzymes in the body. Of these, LD-Immunoglobulin complex is most common. It has reported that LD-IgG or LD-IgA complex existed in the serum of healthy person or many patients who have various clinical disorders. The clinical significance of complexes is not known, but it results in the increase of total LD activity and interference to the LD isoenzyme electrophoresis interpretation due to its anomalous pattern. We have reported a case of LD-Immunoglobulin complex in AILD(Angioimmunoblastic lymphadenopathy with dysproteinemia) with reference. The patient was admitted with fever, chills and cervical LN enlargement, in LN biopsy, diagnosed AILD, and during treatment expired by sepsis. Since admission, serum total LD activities were increased and serum LD isoenzyme EP showed that LD3-5 fractions was not separated in broad single band. Its pattern was due to LD-immunoglobulin complex, LD-bound immunoglobulin was IgG ,lamda. For the identification of immunoglobulin, we at first did serum protein immunoelectrophoresis. then stained the plate with tetrazolium dye for LD activity.