1. Interpretation Difficulties of Serum Immunofixation Test in Immunoglobulin D Multiple Myeloma with Hidden Lambda Light Chains: a Case Report and Review of the Literature.
- Author
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Biaz, A., Uwingabiye, J., Rachid, A., Dami, A., Bouhsain, S., Ouzzif, Z., and El Machtani Idrissi, S.
- Subjects
IMMUNOGLOBULIN D ,MULTIPLE myeloma ,BLOOD serum analysis ,IMMUNOGLOBULIN heavy chains ,IMMUNOPRECIPITATION ,GENETICS - Abstract
Background: We report a case of immunoglobulin (Ig) D myeloma with hidden lambda light chains in a patient whose immunofixation test was very difficult to interpret: the IgD reacts with the anti-δ heavy chain antiserum but does not react with anti-lambda antiserum. The band in the D heavy chain lane is unmatched in light chain lanes and the band in lambda light chain lane migrates higher. Methods: To distinguish between heavy chain disease and immunoglobulin with "hidden" light chains, the sample was exposed to a very high concentration of anti-lambda and anti-kappa antisera for 48 hours. Results: The serum immunofixation test of the sample treated with anti-lambda showed a decrease in the intensity of the band corresponding to D heavy chain lane as well as the modification of its mobility confirming the presence of IgD with the hidden lambda light chains. Conclusions: The IgD myeloma with hidden light chains remains a rare entity, hence the interest of sensitizing health professionals to be vigilant and ensure a good diagnosis. The proposed technique is useful, simple, reliable, and less laborious than those previous reported in the literature. Medical laboratories using Sebia-Hydrasys® system should be aware of the described phenomenon in order to avoid identifying an IgD myeloma as a delta heavy chain disease. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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