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Paraproteins associated with low plasma sodium levels
A Miseta1, M Kellermayer, B Kollar
1Department of Clinical Chemistry, Medical University of Pecs, Hungary.
Physiological Chemistry and Physics and Medical NMR
|January 1, 1989
Summary
The cationic nature of pathological immunoglobulins does not explain low plasma sodium in multiple myeloma. Research shows paraproteins do not exclude sodium, challenging this long-held hypothesis.
Area of Science:
- Biochemistry
- Hematology
Background:
- Multiple myeloma patients can exhibit low plasma sodium levels.
- Pathological immunoglobulins (paraproteins) have been hypothesized to cause this hyponatremia due to their cationic nature.
Purpose of the Study:
- To investigate the role of paraprotein charge in maintaining low plasma sodium levels in multiple myeloma.
- To test the hypothesis that cationic paraproteins cause sodium exclusion.
Main Methods:
- Equilibrium dialysis of patient plasma and purified paraproteins against a sodium chloride solution.
- Polyacrylamide gel electrophoresis of paraproteins under non-denaturing conditions.
Main Results:
- Dialysis of patient plasma confirmed low sodium concentrations.
- Purified paraproteins did not exhibit sodium exclusion during dialysis.
- Electrophoresis indicated paraproteins are not cationic at physiological blood pH.
Conclusions:
- The previously proposed cationic nature of paraproteins does not explain the low plasma sodium levels observed in IgG multiple myeloma.
- Alternative mechanisms must be responsible for hyponatremia in these cases.