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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
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The dark side of current analytic methods for Bence Jones Proteinuria
P Natali1, G Cigliana, C Napodano
1Department of Laboratory Medicine, Azienda Ospedaliero-Universitaria and Azienda Unità Sanitaria Locale, Ospedale Civile di Baggiovara, Modena, Italy. mariapaola.marino@unicatt.it.
European Review for Medical and Pharmacological Sciences
|October 5, 2022
Summary
Bence Jones proteinuria (BJP) detection requires careful urine sample selection and specific methods like immunofixation electrophoresis. Accurate quantification and newer techniques improve monitoring for plasma cell dyscrasias.
Area of Science:
- Clinical Chemistry
- Hematology
- Diagnostic Pathology
Background:
- Bence Jones proteinuria (BJP) involves monoclonal free immunoglobulin light chains in urine.
- It originates from clonal plasma cell expansion in bone marrow disorders.
- BJP is linked to monoclonal gammopathies of uncertain significance.
Purpose of the Study:
- To review diagnostic procedures for assessing BJP.
- To highlight critical pre-analytical, analytical, and post-analytical steps.
- To discuss methods for accurate BJP detection and monitoring.
Main Methods:
- First morning void urine samples are optimal for BJP detection.
- Immunofixation electrophoresis (IFE) with specific antisera is the recommended technique.
- Densitometric analysis of 24-hour urine is standard for quantification; morning urine with creatininuria correlation is an alternative.
Main Results:
- Qualitative tests offer quick BJP evaluation.
- Screening methods are reviewed to minimize false negatives and reduce turnaround time (TAT).
- Immunochemical quantification enhances sensitivity post-IFE confirmation; mass spectrometry is an emerging tool.
Conclusions:
- Utilizing diverse assay methods aids diagnostic accuracy.
- Improved BJP monitoring is crucial for managing monoclonal gammopathies.
- Accurate detection and quantification are key to patient management.
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