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HelpTest ID FHLCA Immunoglobulin A (IgA) Heavy and Light Chain (HLC) Pairs, Kappa and Lambda with Ratio
Specimen Required
Specimen Type: Serum
Container/Tube: Red top or SST
Specimen Volume: 0.75 mL
Collection Instructions: Draw blood in a plain red-top tube, serum gel tube(s) is also acceptable. Separate serum immediately after coagulation (30 minutes) to prevent hemolysis. Send 0.75 mL of serum refrigerated in a plastic vial.
NOTE: Patient should be fasting for eight hours to avoid lipemic sample interference.
Secondary ID
75550Useful For
For the quantitative measurement of human IgA heavy chain and light chain intact immunoglobulin in serum. The result can be used when monitoring previously diagnosed IgA multiple myeloma patients and is used in conjunction with other clinical and laboratory findings.
Heavy and light chain pair quantitation may be useful for:
1. Distinguishing between broadly migrating monoclonal proteins and restricted polyclonal immunoglobulin patterns on serum protein electrophoresis.
2. Quantitating monoclonal IgA proteins that are difficult to quantitate using serum protein electrophoresis alone.
3. Providing a more specific quantitation of the monoclonal protein than total IgA measurements alone.
Method Name
Turbidimetric
Reporting Name
IgA Heavy Light Chains (HLC), SSpecimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Ambient | 14 days | ||
| Frozen | 14 days |
Clinical Information
Elevated serum concentrations of monoclonal protein are indicative of an underlying abnormality, such as monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma, and other lymphoproliferative disorders. International guidelines recommend serum protein electrophoresis (SPE) densitometry to be performed to quantify monoclonal proteins. However, monoclonal IgA proteins can often be obscured by other proteins in the Beta region of a SPE gel, making quantification inaccurate.
Nephelometry can be used in these instances to measure total IgA, but this will include nontumor immunoglobulin, and measurement of either IgA Kappa or IgA Lambda may give a more accurate representation of tumor production. Furthermore, measurement of both IgA Kappa and IgA Lambda, calculation of the IgA Kappa:IgA Lambda ratio and comparison with values found in normal subjects can give a more sensitive indication of clonality. Use of the IgA Kappa:IgA Lambda ratio will also compensate for any changes in plasma volume.
Reference Values
IgA Kappa (g/L): 0.48-2.82
IgA Lambda (g/L): 0.36-1.98
IgA Kappa:IgA Lambda ratio: 0.80-2.04
Cautions
Decisions on patient evaluation and management must not be given on the basis of IgA Kappa, IgA Lambda, or IgA Kappa:IgG Lambda ratio measurements alone. Clinical history and other laboratory findings must be taken into account.
Heavy and light chain (HLC) quantitation should be used as a complementary method to serum protein electrophoresis.
The effect of therapeutic drugs on the measurement of IgA Kappa and IgA Lambda by this assay has not been evaluated.
Small increases in the concentrations of monoclonal IgA proteins may not result in an altered HLC pair ratio.
Day(s) Performed
Tuesday, Friday
Report Available
1 to 9 daysPerforming Laboratory
LabCorp BurlingtonCPT Code Information
83883 x 2