IgE型多发性骨髓瘤的分型检测

目的探讨用免疫固定电泳法检测IgD和IgE单克隆免疫球蛋白，在筛选罕见IgE型多发性骨髓瘤(MM)中的应用价值。方法通过检测血清kD和IgE单克隆免疫球蛋白，从148例MM病人中，筛出只有轻链而不出现IgGAM重链的25份血清样本，用抗游离轻链的单克隆抗体及抗IgD、抗IgE单克隆抗体再进行免疫固定电泳检测。结果25例MM病人中有1例为IgE-κ单克隆免疫球蛋白阳性，24例呈游离轻链阳性(κ型7例、λ型17例)；在17例λ型游离轻链病人中有3例抗λ轻链(游离和结合)病人血清样本呈双克隆带状，用抗IgD单克隆抗体检测证实，有IgD．λ单克隆免疫球蛋白并伴有游离轻链λ。结论采用免疫固定电泳对MM病人血清进行IgG、IgA、IgM和轻链的检测后，用固定免疫技术对只有轻链而不出现IgGAM重链的样本，进行抗游离轻链、抗IgD和抗IgE单克隆抗体分型检测，成功地筛出1例罕见的IgE-κ型MM，提高了对该病的检测水平。

Detection and study of IgE type multiple myeloma

Objective To detect IgD and IgE monoclonal immunoglobulins using serum immunofixations To report and discuss one unusual IgE type multiple myeloma filtered by the method Methods 25 sera samples with light chain and without IgGAM heavy chain screened from 148 multiple myeloma patients were detected by serum immunofixation electrophoresis using anti free light chain,IgD and IgE antibodys Results In 25 sera samples,only one sample had IgE kappa monoclonal immunoglobulin and 24 had free light chain,in which 7 were kappa type and 17 were lambda type in which 3 samples had biclonal strip approved to be IgD monoclonal immunoglobulin accompanying with free lambda light chain Conclusion Routine immunofixation electrophoresis for detection of IgG,IgA,IgM and free light chain can not meet to type multiple myeloma completely It is suggested that samples with light chain and without IgGAM heavy chain must be type using anti free light chain,IgD and IgE antibodys Based on our experience of screening one case of IgE K type multiple myeloma , We could be that it can be helpful to gain more acquaintance of the disease through our report [