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Clinical Chemistry, Vol 37, 1570-1574, Copyright © 1991 by American Association for Clinical Chemistry
EM MacNamara, F Aguzzi, C Petrini, J Higginson, C Gasparro, MR Bergami, G Bianchi and JT Whicher
Department of Chemical Pathology, University of Leeds, U.K.
The detection of Bence Jones protein, an important part of the investigation of suspected myeloma, is most commonly done by agarose or cellulose nitrate electrophoresis followed by immunofixation. Bence Jones protein is recognized as single or multiple bands of one type of light chain. Unfortunately, improvements in sensitivity of these techniques (use of high-affinity antisera and higher resolution electrophoresis) frequently allow detection of multiple light chain bands in the urine of patients who do not have a B-cell dyscrasia. The bands are usually kappa, although they may be accompanied by lambda bands. This pattern may lead to the misdiagnosis of Bence Jones protein and oligoclonal light chain production in patients. Here we show that this pattern is produced by polyclonal light chains; it is present in the urine of all patients with a tubular proteinuria of any etiology and may be induced in healthy individuals by blocking their renal tubular protein reabsorption. Polyclonal light chains separate into monomers and dimers on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and into four major bands with many minor bands by isoelectric focusing. This difference in charge and possibly size results in the banding pattern seen on good-quality electrophoresis and immunofixation.
The following articles in journals at HighWire Press have cited this article:
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  M. R. Nowrousian, D. Brandhorst, C. Sammet, M. Kellert, R. Daniels, P. Schuett, M. Poser, S. Mueller, P. Ebeling, A. Welt, et al. Serum Free Light Chain Analysis and Urine Immunofixation Electrophoresis in Patients with Multiple Myeloma Clin. Cancer Res., December 15, 2005; 11(24): 8706 - 8714. [Abstract] [Full Text] [PDF]
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 J. A. Viedma, N. Garrigos, and S. Morales Comparison of the Sensitivity of 2 Automated Immunoassays with Immunofixation Electrophoresis for Detecting Urine Bence Jones Proteins Clin. Chem., August 1, 2005; 51(8): 1505 - 1507. [Full Text] [PDF]
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K. Matsuda, N. Hiratsuka, T. Koyama, Y. Kurihara, O. Hotta, Y. Itoh, and K. Shiba Sensitive Method for Detection and Semiquantification of Bence Jones Protein by Cellulose Acetate Membrane Electrophoresis Using Colloidal Silver Staining Clin. Chem., April 1, 2001; 47(4): 763 - 766. [Full Text] [PDF]
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M. Attaelmannan and S. S. Levinson Understanding and Identifying Monoclonal Gammopathies Clin. Chem., August 1, 2000; 46(8): 1230 - 1238. [Abstract] [Full Text] [PDF]
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T. Le Bricon, D. Erlich, D. Bengoufa, M. Dussaucy, J.-P. Garnier, and B. Bousquet Sodium dodecyl sulfate-agarose gel electrophoresis of urinary proteins: application to multiple myeloma Clin. Chem., June 1, 1998; 44(6): 1191 - 1197. [Abstract] [Full Text] [PDF]
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M. Kemper and S. S. Levinson Serum Proteins in Clinical Medicine, Vol. 1, Laboratory Section, 1st ed. Robert Richie, ed., Olga Navolotskaia, asst. ed. Foundation for Blood Research, PO Box 190, Scarborough ME 04070-0190. Clin. Chem., March 1, 1997; 43(3): 550A - 551. [Full Text]
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