Demirel Naciye YILDIRIM, Mesut AYER, Esra HATİPOĞLU, Diz Reyhan KÜÇÜKKAYA, Mustafa Nuri YENEREL, Meliha NALÇACI

Atypical M-protein localization in protein electrophoresis in a patient with multiple myeloma

Monoklonal gamopati, belirli bir monoklonal immünglobulin (M-protein) sekresyonuna yol açan B-hücre bozukluklarının bir grubudur. Monoklonal bir proteinin belirlenmesinde en iyi yöntem, yüksek çözünürlüklü agaroz jel elektroforezidir. Bu test elektroforezde proteinlerin migrasyon anormalliklerini gösterir ve serum ya da idrar örnekleri üzerinde uygulanabilir. M-proteini genellikle, agaroz jel elektroforezi densitometre kayıtlarında gama, beta bölgelerinde, nadiren de alfa-2 globulin bölgesinde bir bant şeklinde görülebilir. Bu yazıda, agaroz jel elektroforezinde, alfa-2 globulin bölgesinde M bandına sahip IgA kappa paraproteinemili bir multipl miyelom olgusu sunuldu

Anahtar Kelimeler:

Elektroforez, Paraproteinemiler, Kadın, Multipl miyelom, Yaşlı

Multipl miyelomlu bir olguda protein elektroforezinde atipik M-proteini

Monoclonal gammopathy is a group of B-cell disorders resulting in the secretion of a specific and unique monoclonal immunoglobulin (M-component). The best method for detecting a monoclonal protein is high resolution agarose gel electrophoresis. This test detects abnormalities in the migration of the proteins on electrophoresis and can be performed with samples of serum or urine. An M-protein is usually visible as a localized band on agarose gel electrophoretic peak in the beta, gamma, or rarely in the alpha-2 globulin region of the densitometer tracing. Here, we presented a multiple myeloma patient with IgA kappa paraprotein showing an M spike in the alpha-2 globulin region in agarose gel electrophoresis.

Keywords:

Electrophoresis, Paraproteinemias, Female, Multiple Myeloma, Aged,

PDF

___

1) Kyle AR, Rajkumar SV, Lust AJ. Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma. In: Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B, editors. Wintrobe's clinical hematology. Chapter 97. 11th ed. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 2566-7.
2) Longo DL. Plasma cell disorders. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, et al., editors. Harrison's principles of internal medicine. Vol. 1, Chapter 114. 14th ed. New York: McGraw-Hill Co; 1998, p. 712-8.
3) Kyle RA, Rajkumar SV. Plasma cell disorders. In: Goldman L, Ausiello D, editors. Cecil textbook of medicine. Chapter 196. 22nd ed. Philadelphia: W. B. Saunders; 2004. p. 1184-6.
4) O'Connell TX, Horita TJ, Kasravi B. Understanding and interpreting serum protein electrophoresis. Am Fam Physician 2005;71:105-12.
5) Mseddi-Hdiji S, Haddouk S, Ben Ayed M, Tahri N, Elloumi M, Baklouti S, et al. Monoclonal gammapathies in Tunisia: epidemiological, immunochemical and etiological analysis of 288 cases. Pathol Biol (Paris) 2005;53:19-25. [Abstract]
6) Bakta IM, Sutarka IN. Biclonal gammopathy in multiple myeloma: a case report. Gan To Kagaku Ryoho 2000;27 Suppl 2:544-8.
7) Tunstall AM, Merriman JM, Milne I, James K. Normal and pathological serum levels of alpha2-macroglobulins in men and mice. J Clin Pathol 1975;28:133-9.
8) Caterini V, Smorti G, Biotti MB. The IgA myeloma, personal contribution and review of the literature. (author's transl) Quad Sclavo Diagn 1978;14:250-8. [Abstract]