Laboratory Support for Diagnosis of Amyloidosis
Serum- and urine-based laboratory testing are important initial observations in helping to guide both the differential diagnosis of primary amyloidosis (AL) and the testing for identifying and characterizing tissue amyloid. The fibrils in AL are derived from intact or fragmented monoclonal immunoglobulin light chains. These patients have intact free monoclonal immunoglobulin and/or free immunoglobulin light chains detected in the serum and/or urine. The purpose of this chapter is to describe the methods used to detect plasma cell proliferation disorders and to identify excess monoclonal free light chain (FLC) synthesis. Specifically, the value of protein electrophoresis (PEL), immunofixation electrophoresis (IFE), and quantitative serum FLC)analysis will be presented. These tests are not only useful in the differential diagnosis of amyloidosis but also have a role in early disease detection, prognosis, and monitoring of AL.
KeywordsFree light chains Serum protein electrophoresis Urine protein electrophoresis Nephelometry Immunofixation electrophoresis Primary (AL) amyloidosis
- 7.Hoffman JE, Hassoun H, Landau H, Comenzo RL. Coincindal gammopathies in patients with systemic amyloidosis and transthyretin gene mutations. Proceedings of the 52nd ASH annual meeting, Orlando, FL; 2010.Google Scholar