Clinical and laboratory aspects of biclonal gammopathy of undetermined significance - BGUS


Authors: T. Pika 1;  P. Lochman 2;  V. Maisnar 3;  M. Tichý 4;  J. Minařík 1;  R. Hájek 5;  V. Ščudla 1
Authors‘ workplace: III. interní klinika – nefrologická, revmatologická, endokrinologická, LF UP a FN Olomouc 1;  Oddělení klinické biochemie, FN Olomouc 2;  IV. interní hematologická klinika, LF UK a FN Hradec Králové 3;  Ústav klinické biochemie a diagnostiky, LF UK a FN Hradec Králové 4;  Ústav klinické hematologie, LF OU a FN Ostrava 5
Published in: Klin. Biochem. Metab., 21 (42), 2013, No. 2, p. 83-87

Overview

Introduction:
Biclonal gammopathy of undetermined significance (BGUS) is a less frequent disease characterized by the presence of two monoclonal gradients and a relatively favourable biological development.

Objective:
The objective was to assess potential benefits and/or limitations of laboratory parameters typically used with monoclonal gammopathy of undetermined significance (MGUS) when applied to a group of BGUS patients.

Methods:
The analysed batch comprised 18 serum samples from BGUS patients (9x IgG–IgA, 7x IgG–IgM a 2x IgG–IgG type). The assays were performed with a SPA Plus turbidimeter. Serum levels of polyclonal immunoglobulins, free light immunoglobulin chains (FreeLite™), and pairs of heavy/light immunoglobulin chains (HevyLite™) were assayed.

Results and conclusion:
The results of the pilot analyses confirm that a significant portion of BGUS patients exhibits changes of certain parameters typically applied to the stratification and monitoring of MGUS patients, particularly when the light chains in both molecules of monoclonal immunoglobulins differ. The analysis of heavy/light immunoglobulin chain pairs (HLC) appears very promising, indicating the possibility of an isotype suppression of the alternative pair affecting the HLC index. It is apparent, however, that the isolation and analysis of cell clones on a molecular and cytogenetic level will be essential for BGUS prognosis in clinical practice.

Key words:
biclonal gammopathy, prognostic factors, diagnostics.


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