English 
Italian CASI CLINICI – Case Reports
Volume:
Biochimica Clinica 2013; 37(5) 428-430
Pubblicato on-line:
DOI:
Un caso particolare di mieloma micromolecolare lambda
AUTORI
1Unità Operativa Complessa Medicina di Laboratorio, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale - IRCCS, Napoli
2Unità Operativa Complessa Ematologia, Azienda Ospedaliera, Cosenza
ABSTRACT
A particular case of lambda chain multiple myeloma
The measurement of serum free light chains (FLC) is recommended for diagnosis, monitoring and prognosis of monoclonal gammopathies and specific assays on automated nephelometers and turbidimeters are available. We reported a case study about a 47-years old woman with bone pain, admitted to the Orthopedic Day Surgery. Serum protein electrophoresis (SPE) both on agarose gel (AGE) and capillary zone electrophoresis (CZE) did not show abnormalities and nephelometric assays of intact immunoglobulins and total light chains were within the respective reference intervals. A relevant difference between the l FLC results was obtained using two serum FLC assays, resulting highly abnormal by the Freelite (The Binding Site) and within the reference interval by the N Latex FLC (Siemens Healthcare Diagnostics). A home-made high resolution AGE, performed both in serum and urine samples, detected a monoclonal component (MC) in the g-region and serum and urine immunofixation electrophoresis (IFE) showed a free l MC. Immunoblotting and SDS-PAGE confirmed the presence of a FLC and showed that the MC consisted of l FLC with MW of 22,000 and 44,000 Da. Bone biopsy confirmed the diagnosis of l chain multiple myeloma. The woman was admitted to the Hematology- Oncology Unit and one month after the start of the therapy, serum and urine IFE showed the MC disappearance and the serum FLC results by Freelite assays returned within the reference interval.