A Case of IgM Paraproteinemia in Which Serum Free Light Chain Values Were Within Reference Intervals

[摘要] We read with interest the recent paper on the combination of serum protein electrophoresis (SPEP) and serum free light chain (FLC) assay as a potential alternative to SPEP and urine protein electrophoresis (UPEP) screening for paraproteinemia (1), as well as the accompanying editorial on sensitivity and specificity issues of the serum FLC assay (2). This assay, which first became commercially available in 2001, is used to diagnose and monitor light chain myeloma, primary amyloidosis, and related light chain diseases. Despite the usually quoted high clinical sensitivity of serum FLC assay in detecting light chain disease, results within reference intervals can occur with intact immunoglobulin paraproteinemia (3). We describe a patient with IgM paraproteinemia who showed FLC concentrations and κ:λ ratio within reference intervals.A 79-year old Chinese woman presented with blurred vision due to hyperviscosity syndrome and bleeding tendency. Physical examination showed no hepatosplenomegaly …

[学科分类] 过敏症与临床免疫学