Because of the strong clinical heterogeneity and the varying SPEP patterns with an inconstant presence of a monoclonal peak, [gamma]-HCD is thought to be an underdiagnosed disease.
In accordance with other reports, a monoclonal peak with a [beta] mobility was present after both SPEP and UPEP.
In both samples the CZE electropherograms showed a minor disturbance in morphology of the [gamma]-region but not the obvious monoclonal peak
that was observed with agarose gel electrophoresis.
The sorted tumor cell population had a monoclonal peak
profile with amplicons at 115 and 164 by for IgH FR3, 254 by for FR2, and 314 and 360 by for FR2 (data not shown).
1 in the Data Supplement, available with the online version of this Letter at http://www.clinchem.org/content/vol49/issue4/) demonstrated a prominent monoclonal peak
in the [gamma] region consistent with this patient's previous analyses and known IgG[kappa] paraprotein.
All 14 samples with clinical, histologic, and immunohistochemical evidence of T-cell lymphoma showed either a single, monoclonal peak
or a very prominent monoclonal peak
in a polyclonal background.
Comigration of such proteins with the BJP may hinder proper identification and quantification of the monoclonal peak
. These problems have been discussed elsewhere (16).
No monoclonal peak
or irregularity could be seen in the CZE curve for one sample from a 92-year-old woman containing an IgG MC estimated as 1 g/L with normal background immunoglobulin synthesis and no cryoglobulin.
The specificity of the immunospecific binder that caused the disappearance of the monoclonal peak
identifies the paraprotein.
Specifically, both specimens showed identical monoclonal peaks
of 332 and 346 base pairs in the IgH FR1 region.
Clear monoclonal peaks
(9-31 g/L) in the [gamma]-globulin area were not affected (data not shown).
Furthermore, under some circumstances, benign monoclonal peaks
without plasma cell neoplasia exist.