This question was answered on Fri 15, Feb 2008 07:00pm by Dr Bobby V, MD

Serum Immunofixation test result - What does IgG Kappa monoclonal protein detected in serum immunofixation test mean?

    
Asked by Unregistered on Fri 15, Feb 2008 09:23am

What does IgG Kappa monoclonal protein detected in serum immunofixation test mean? This is a follow up test for the protein electrophoresis test which detected a presence of monoclonal protein band.

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Answer by Dr Bobby V, MD  on Fri 15, Feb 2008 07:00pm:

Hi, The patient in question is being worked up for suspected multiple myeloma. Patients with multiple myeloma secrete abnormal levels of certain proteins called M protein. The investigation of M protein involve the following steps. First, the M protein is detected using protein electrophoresis. Second, the nature of the M protein is identified using Immunoelectrophoresis or Immunofixation. Lastly, the amount of M protein may be quantified using a test known as Single Radial Immunodiffusion or other techniques. To give a brief background, Protein Electrophoresis is used to seperate out the different protein classes present in blood serum using a small electric current. The seperated protein classes form different bands, and these are labelled as Albumin, Alpha 1, Alpha 2, Beta, and Gamma. The doctors are specifically interested in the Gamma band, and check if this Gamma band on electrophoresis is broad or narrow. Normal patients have a diffuse, broad Gamma band. In patients with multiple myeloma, PEP reveals a single, sharp protein band in the Gamma region. The initial protein electrophoresis (PEP) of the patient revealed a monoclonal protein band. This strengthened the clinical suspicion of Multiple Myeloma, and the next test, or serum Immunofixation test was ordered. A brief background of the Immunofixation test: We know that patients of multiple myeloma secrete immunoglobulins. These contain sub-parts called heavy-chains and light-chains. The heavy chains are usually of a type called IgG, may sometimes be IgA, and rarely be IgM, IgD, or IgE. The light chains in multiple myeloma patients are either Kappa or Lambda but not both. Normal patients have both Kappa and Lambda. The Immunofixation test thus identifies the type of light chain that a particular patient has; in this case the test was Kappa positive. The patient in question should now undergo other routine blood investigations, liver function tests, renal function tests, bone marrow aspirate and biopsy examination, radiological skeletal survey, and serum beta microglobulin test. Treatment should begin after confirming diagnosis and appropriate staging procedures.

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Comment by Jay Keating on Tue 30, Nov 2010 07:05am:
My Immunofixation test revealed an IgG Kappa Monoclonal protein migrating in gamma region. The reference Range showed no Monoclonal Protein Detected. What does this mean?

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