Myeloma + paraproteins - SEE TABLE Flashcards
To understand the basics of normal immunoglobulin structure, function and production
To understand the tests used to assess immunoglobulins
- Serum immunoglobulin levels
- Electropheresis + immunofixation
- Serum light chain levels/ urine Bence Jones protein
Understand the term paraprotein
To understand the clinical presentation and treatment of conditions associated with paraproteins
.
Shape of an antibody
Y-shaped
Antibody contains 4 chains
2 inner HEAVY chains
2 outer LIGHT chains
5 types of heavy chains
Gamma – IgG Alpha – IgA Mu – IgM Delta – IgD Epsilon - IgE
Initial phase of antibody production involves which immunoglobulin
IgM
Most prevalent antibody in blood
IgG
Which antibody provides immunity to mucosal surfaces
IgA
2 types of light chains
Kappa
Lambda
Light chains can show up in the urine
What is the special name them for them if detectable in the urine
Bence Jones protein (BJP)
An antibody (immunoglobulin) has 2 special regions
- Fab
- Fc
Describe these
Fab - antigen binding fragment, i.e. the part that binds to an antigen
Fc - defines which class of antibody it is, i.e. IgM, IgG etc
Tests used to assess immunoglobulins (3)
Serum immunoglobulin levels
Electropheresis + iimmunofixation
Serum light chain levels/urine Bence Jones protein
What is a paraprotein (monoclonal gammopathy)
Monoclonal immunoglobulin present in the blood or urine and arising from clonal proliferation of mature B‐cells,
Arises only in cancers
Serum protein electropheresis separates proteins based on what 2 properties of the protein
Size + charge
MAIN TEST TO IDENTIFY PRESENCE OF PARAPROTEINS
Serum electrophoresis; NOT TOTAL IMMUNOGLOBULIN LEVELS (as this doesn’t tell anything about paraproteins)
If IgM paraproteins present, indicates what malignancy
Lymphoma
