Assessment of the diagnostic performances of IgA heavy and light chain pairs in patients with IgA monoclonal gammopathy |
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| Authors: | Fleur Wolff France Debaugnies Laurence Rozen Dominique Willems Fabian Brohet Jonathan Brauner Patrick Stordeur |
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| Affiliation: | 1. Laboratory of Clinical Chemistry, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium;2. Laboratory of Clinical Chemistry and Haematology, Brugmann Hospital, Brussels, Belgium;3. Immunobiology Clinic, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium;1. Program in Chemistry and Chemical Biology, University of California, San Francisco, San Francisco, CA 94158, USA;2. Department of Pharmaceutical Chemistry, University of California, San Francisco, San Francisco, CA 94158, USA;3. Graduate Group in Biophysics, University of California, San Francisco, San Francisco, CA 94158, USA;1. Melville Analytics Pty Ltd, Jindabyne, Australia;2. C Y O’Connor ERADE Village Foundation, Piara Waters, Australia;1. Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic, Barcelona, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), José Carreras Leukaemia Research Institute, University of Barcelona, Barcelona, Spain;2. Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, School of Medicine, University of Barcelona, Barcelona, Spain;1. Chemical Engineering Department, ETSEIAT, Universitat Politècnica de Catalunya, Colom 11, E-08222 Terrassa, Spain;2. Chemical Engineering Department, Physical Chemistry and Organic Chemistry, University of Huelva (ceiA3), Spain;3. Textile and Paper Engineering Department, ETSEIAT, Universitat Politècnica de Catalunya, Colom 11, E-08222 Terrassa, Spain |
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| Abstract: | ObjectivesPreliminary results of the IgA Hevylite? assay including the establishment of the 95% reference interval and assessment of the specificity and sensitivity in different populations are reported.Design and methodsThe concentrations of IgA heavy and light chains (HLC) enabling to determine an IgAκ/IgAλ ratio were quantified in 119 apparently healthy individuals to generate 95% reference intervals. The specificity of this assay was assessed in 48 patients with an isolated polyclonal IgA increase. In a retrospective analysis of 68 patients with a monoclonal component type IgA (MC-IgA) identified by serum immunofixation (IFE), IgA HLC ratio values were compared with known results for serum protein electrophoresis (SPE) and free light chain (FLC) ratios.ResultsThe 95% reference range obtained in 119 controls (0.91–2.04) was close to that quoted by the manufacturer (0.80–2.04). Eight of the 48 patients (16.7%) with a polyclonal IgA increase had an IgA HLC ratio above the upper limit of the 95% reference interval.The IgA HLC ratio identified 65 (95.6%) among 68 patients with MC-IgA identified on the basis of IFE. For 34 of these patients (50%), MC-IgA was not detected by SPE due to its co-migration with alpha-2 or beta-globulins.ConclusionsCompared with serum IFE, the IgA HLC ratio has a sensitivity of 95.6%. Further studies are needed to assess the specificity of the IgA HLC ratio in patients with an isolated polyclonal increase of serum IgA. |
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