Indian Journal of Clinical Biochemistry

, Volume 34, Issue 1, pp 76–81 | Cite as

A Study on Free Light Chain Assay and Serum Immunofixation Electrophoresis for the Diagnosis of Monoclonal Gammopathies

  • Eldho Kuriakose
  • Sumithra Narayanan Unni CheppayilEmail author
  • Subhakumari Kuzhikandathil Narayanan
  • Anu Vasudevan
Original Research Article


Demonstration of monoclonal immunoglobulin molecule in serum forms the mainstay in the diagnosis of monoclonal gammopathies. The major tests that help in this regard are serum protein electrophoresis (SPEP), serum immunofixation electrophoresis (sIFE) and serum free light chain assay (sFLC). Our objectives were to study the accuracy of sFLC and sIFE in the diagnosis of monoclonal gammopathies and also to study the role of combination of SPEP + sIFE + sFLC in the diagnosis of the same. 46 patients who attended the hemato-oncology clinic with signs and symptoms suggestive of monoclonal gammopathy were enrolled in this study. SPEP, sIFE, sFLC and pre-treatment serum beta-2 microglobulin levels were analysed among the study population. Both SPEP and sIFE were performed in the Interlab Genios fully automated machine. Serum beta-2 microglobulin and sFLC were estimated by immunoturbidimetry in Beckman Coulter AU 2700 analyzer. The accuracy of sIFE came to be 80% with respect to sFLC assay. Sensitivity, specificity, positive and negative predictive value of sIFE with respect to sFLC were 81.3, 78.6, 89.7 and 64.7% respectively. It was observed that a combination panel of SPEP + sIFE + sFLC could detect all the cases of myeloma included in this study. Further testing in large samples is required for generalising the findings of this study. The pre-treatment beta-2 microglobulin levels were significantly higher in the group which was positive for myeloma. A combination panel of SPEP + sIFE + sFLC prove to be more useful than individual tests for the detection of myeloma.


Monoclonal immunoglobulin Serum protein electrophoresis MGUS Serum immunofixation electrophoresis Plasma cell dyscrasias 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Association of Clinical Biochemists of India 2017

Authors and Affiliations

  • Eldho Kuriakose
    • 1
  • Sumithra Narayanan Unni Cheppayil
    • 1
    Email author
  • Subhakumari Kuzhikandathil Narayanan
    • 1
  • Anu Vasudevan
    • 2
  1. 1.Department of Biochemistry, Amrita Institute of Medical Sciences and Research Centre (AIMS)Amrita Viswa Vidyapeetham UniversityKochiIndia
  2. 2.Department of Biostatistics, Amrita Institute of Medical Sciences and Research Centre (AIMS)Amrita Viswa Vidyapeetham UniversityKochiIndia

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