Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (1013 page)

   Waldenström macroglobulinemia

   Amyloidosis

   Light chain deposition disease

   Connective tissue diseases such as SLE

   Renal impairment (common)

   Overproduction of polyclonal free light chains (FLCs) from inflammatory conditions (common)

   Biclonal gammopathies of different FLC types (rare)

TABLE 16–45. Interpretation of Serum Free Light Chain Assays in Serum

Decreased In

   Bone marrow function impairment

   Limitations

   Elevated kappa and lambda FLC may occur due to polyclonal hypergammaglobulinemia or impaired renal clearance. A specific increase in FLC (e.g., FLC kappa/lambda ratio) must be demonstrated for diagnostic purposes.

Suggested Readings

Bradwell AR.
Serum Free Light Chain Analysis
, 2nd ed. Birmingham, UK: The Binding Site Ltd; 2005:13–21.

Katzmann JA, Clark RJ, Abraham RS, et al. Serum reference intervals and diagnostic ranges for free κ and free λ immunoglobulin light chains: Relative sensitivity for detection of monoclonal light chains.
Clin Chem.
2002;48:1437–1444.

IMMUNOSUPPRESSANTS
*

   Definition

   Cyclosporin A is a cyclic polypeptide containing 11 amino acids. It is produced by the fungus
Tolypocladium inflatum
.