English 
Italian CASI CLINICI – Case Reports
Volume:
Biochimica Clinica 2019; 43(4) e35-e36
Published on-line:
October 10, 2019
DOI:
10.19186/BC_2019.059
Una paziente con dolori ossei diffusi: il ruolo del laboratorio nel diagnosticarne la causa
AUTHORS
1Dipartimento di Medicina di Laboratorio e Anatomia Patologica, AOU-AUSL Modena
2Dipartimento integrato di Oncologia, Ematologia e Malattie dell’apparato respiratorio, AOU-Policlinico di Modena
ABSTRACT
A female patient with diffuse bone pain: the role of the clinical laboratory in the diagnostic process
Multiple myeloma (MM) represents 10% of all hematologic malignancies; in 15% of MM the monoclonal component consists of only free light chains. A 53 year-old patient performs at the Corelab laboratory (AOU-AUSL Modena) blood tests for bone pain. Serum electrophoresis shows hypogammaglobulinemia (5,5 g/L). The laboratory professional decides to carry on further studies: a serum immunofixation that highlighted the presence of kappa free light chains not traceable to any heavy chain and the measure of the serum free light chains (sFLC) with the following results: FLC-κ 26 777 mg/L (i.r. 3.3-19.4); FLC-λ 6.15 mg/L (i.r. 5.7-26.3); ratio FLC (rFLC), 435.31 (i.r. 0.26-1.65). The light chain MM is a type of MM difficult to recognize. The laboratory professional’s own initiative defines a procedure of “personalized medicine” oriented to to the patient’s needs. The expertise of the laboratory professional is crucial in assuring the patient the best outcome when carried out on the basis of the available guidelines.