Editor-in-chief
Maria Stella Graziani

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Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
☩Howard Morris Australia
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
☩Jill Tate Australia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada


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Responsible Editor
Giuseppe Agosta

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Arianna Lucini Paioni
Biomedia srl
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email: biochimica.clinica@sibioc.it



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Articoli con TAG: catene leggere

La spettrometria di massa nella diagnosi e nel monitoraggio delle gammopatie monoclonali
Mass spectrometry in diagnosis and monitoring of monoclonal gammopathies
<p>The identification ofmonoclonal components requires the use of protein electrophoresis, immunofixation electrophoresis of serum andurine and serum free light chain measurement. The combination of these three tests grants the highest diagnosticperformance in different clinical settings. In clinical practice, the monoclonal protein (M-protein) is detected in apatients&rsquo; serum or urine by the appearance of a distinct protein band migrating within regions typically occupied byimmunoglobulins. Immunofixation or immunotyping then provides evidence that the identified protein band is anintact immunoglobulin or an immunoglobulin light chain. Taking into consideration that each M-protein is composedby a sequence of amino acids pre-defined by somatic recombination unique to each clonal plasma cell, the molecularmass of the M-protein can act as a surrogate marker of the protein composition. The Mayo Clinic researchersestablished mass spectrometry-based methods to assign molecular mass to the monoclonal immunoglobulin lightchain and used this to detect the presence of M-proteins. The first method proposed is based on the enrichment ofserum for immunoglobulins, followed by reduction to separate light chains from heavy chains, followed by microflowLC-ESI-Q-TOF mass spectrometry. The second method is based on the enrichment of nanobodies and thesubsequent analysis on a matrix-assisted laser desorption mass spectrometer (MALDI). Both methods demonstrateda comparable diagnostic sensitivity to the standard procedures and could be considered as a possible futuresubstitution of immunofixation.</p>
Biochimica Clinica ; 43(3) 256-263
Rassegne - Reviews
 
Una paziente con dolori ossei diffusi: il ruolo del laboratorio nel diagnosticarne la causa
A female patient with diffuse bone pain: the role of the clinical laboratory in the diagnostic process
<p>Multiple myeloma (MM) represents 10% of all hematologic malignancies; in 15% of MM the monoclonal component consists of only free light chains. A 53 year-old patient performs at the Corelab laboratory (AOU-AUSL Modena) blood tests for bone pain. Serum electrophoresis shows hypogammaglobulinemia (5,5 g/L). The laboratory professional decides to carry on further studies: a serum immunofixation that highlighted the presence of kappa free light chains not traceable to any heavy chain and the measure of the serum free light chains (sFLC) with the following results: FLC-&kappa; 26 777 mg/L (i.r. 3.3-19.4); FLC-&lambda; 6.15 mg/L (i.r. 5.7-26.3); ratio FLC (rFLC), 435.31 (i.r. 0.26-1.65). The light chain MM is a type of MM difficult to recognize. The laboratory professional&#39;s own initiative defines a procedure of &quot;personalized medicine&quot; oriented to to the patient&#39;s needs. The expertise of the laboratory professional is crucial in assuring the patient the best outcome when carried out on the basis of the available guidelines.</p>
Biochimica Clinica ; 43(4) e35-e36
Casi Clinici - Case Report