• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1483-1486
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• 2012

Objective: To determine the characteristics of oligoclonal bands that are frequently detected by serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE) after stem cell transplantation. Methods: We retrospectively analyzed 56 patients with multiple myeloma (MM) undergoing transplantation, and standard immunofixation electrophoresis was used to identify and quantify paraproteins. Results: The median follow-up was 35 months (range, 10-76months) and 21 patients relapsed. Twelve (25.0%) demonstrated oligoclonal bands after a median time 1.4 months (range, 1-3months), with a median duration of 5.8 months (range, 1-15months). The majority patients with oligoclonal bands had normal quantities of immunoglobulins and the one year event free survival (EFS) was 92%, even higher than for patients without OBs (P=0.002). Conclusion: Oligoclonal bands frequent develop post-transplantation in MM cases. In the vast majority of patients, they may not represent relapsed disease, and more likely represent a transient phenomenon representing recovery of impaired immunoglobulin production.

• Korean Journal of Clinical Laboratory Science
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• v.41 no.4
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• pp.173-179
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• 2009

The analysis of serum free light chains (sFLCs) can improve the diagnosis and monitoring of multiple myeloma and other plasma cell dyscrasias. As with other immunoassays, sFLCstests are subject to potential antigen excess and heterophilic antibody interference. We describe 9 cases of sFLCs antigen excess in patients with multiple myeloma using the FreeliteTM Human Kappa and Lambda Free Kits (The Binding Site ltd., Birmingham, UK) and the Hitachi7600 P module turbidimetric system. A total of 1,247 consecutive samples from 250 patients with multiple myeloma were assayed for sFLCs from April to September, 2009. The samples were assayed using an initial dilution of 1 :5and subsequent dilutions of 1 :50 and 1: 100. The same samples were analyzed for the presence of monoclonal gammopathies using serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE). There were 9 samples (0.72%) of antigen excess with 3 cases of kappa (0.24%) and 6 cases of lambda (0.48%). These cases represents an example of antigen excess or "hook effect" using the serum free light chain assays and mandates high level of attention to falsely low sFLC levels due to antigen excess, especially when it is disaccordant to other assay results or clinical manifestations.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.588-591
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• 2009

Radiologic findings of Bing-Neel syndrome, which is an extremely uncommon complication resulting from malignant lymphocyte infiltration into the central nervous system (CNS) in patients with Waldenstr$\ddot{o}$m's macroglobulinemia (WM), have been infrequently reported due to extreme rarity of the case. A 75-year-old man with WM presented at a neurology clinic with progressive gait and memory disturbances, and dysarthria of 2 months duration. Cerebrospinal fluid and serum protein electrophoresis and immunofixation electrophoresis showed IgM kappa-type monoclonal gammopathy. Brain magnetic resonance imaging revealed multifocal, hyperintense lesions on T2 weighted-images. Brain diffusion-weighted imaging (DWI) demonstrated hyperintensities in cerebral and cerebellar lesions that appeared isointense on apparent diffusion coefficient maps, which were compatible with vasogenic edema. Although histologic analysis is a confirmative study to prove direct cell infiltration into the brain, brain MRI with DWI may be a good supportive study to diagnose Bing-Neel syndrome.

• Annals of Clinical Neurophysiology
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• v.11 no.2
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• pp.71-73
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• 2009

Biclonal gammopathy is characterized by the presence of two different monoclonal immunoglobulins, and the clinical findings of biclonal gammopathy are similar to those of monoclonal gammopathy. An association between biclonal gammopathy and tsutsugamushi meningitis has not been reported previously. Here, we report a case of a 55-year-old man presented with fever and decreased mentality. A cerebrospinal fluid (CSF) test and an indirect immunofluorescent antibody test for Orientia tsutsugamushi revealed tsutsugamushi meningitis. CSF and serum immunofixation electrophoresis revealed biclonal gammopathy (IgG-${\kappa}$, IgG-${\lambda}$). His symptoms improved after antibiotics treatment, and serum biclonal gammopathy completely disappeared.