Methods
Blood samples were collected using serum dry tubes, the samples left to clot for one hour before centrifugation at 1000 RPM for 15 minutes. Total protein (g/L), C-reactive protein ̵̎CRP˝ (mg/l), Calcium (mg/l), creatinine (mg/l), urea(g/l) were measured with Dimension Rxl Siemens analyzer®. The β2-microglobulin and the immunoglobulins (IgA, IgG and IgM) was measured with an immunonephelometer analyzers from Dade Behring BN II ®. The Sedimentation rate was measured at the first hour (mm) (SRFH). Hemoglobin (Hb) (g/dl) was measured with the Beckman Coulter hematology analyzers (reference values: In woman Hb ˂12 g/dl, in men Hb˂13 g/dl). Urine immunofixation was performed in urine samples collected for 24 hours.
Protein electrophoresis was performed on all samples with capillary electrophoresis system from Sebia®. Immunofixation was performed in the following situations when an abnormal serum protein electrophoresis was defined by the presence of a quantifiable Monoclonal spike, hypogammaglobulinemia and a fuzzy band. Furthermore, when we have an increased numbers of abnormal, atypical or immature plasma cells in the bone marrow, hypercalcemia, histological proof of plasmacytoma and high SRFH.
Serum and urine immunofixation were performed on Hydrasys Sebia®. Patient records have been reviewed for clinical history and the monoclonal protein type. The diagnosis of monoclonal gammopathies is based on the presence of an increase in the number of plasma cells and/or immature and dystrophic plasma cells in the marrow, the presence of histological evidence of plasmacytoma, the presence of monoclonal protein in the serum and urine and/or bone lesions.