Specific lab tests to diagnose myeloma
What specific laboratory diagnostic tests are used for the diagnosis of myeloma?
Serum protein electrophoresis (SPE) by separation of protein upon an agarose gel can detect the whole Ig in the range of 1 to 5 g/dL, but it only detects increased LC in patients who have very high levels of LC-only myeloma, and it is semi-quantitative. Serum immunofixation electrophoresis (IFE) is around 10 times more sensitive for Igs and LC, but it is not quantitative. Urine IFE requires concentrated urine samples for the detection of FLCs and can detect low levels of LC. The detection of urine LC by the primitive techniques of boiling and precipitation was one of the earliest descriptions of myeloma disease “mollities ossium” and its manifestations published in 1847 by Dr. Henry Bence-Jones. Subsequently Korngold and Lapiri (designated Kappa and Lambda) raised antisera against the two LC domains. Bence-Jones proteins are urinary FLCs detected by urinary protein electrophoresis and immunofixation.
