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HelpTest Code FHLC Immunoglobulin M (IgM) Heavy and Light Chain (HLC) Pairs, Kappa and Lambda with Ratio
Specimen Required
Patient Preparation: Patient should be fasting for eight hours to avoid lipemic sample interference.
Specimen Type: Serum
Collection Container/Tube: SST or Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.75 mL
Collection Instructions:
1. Draw blood in a plain red-top tube, serum gel tube(s) is also acceptable.
2. Separate serum immediately after coagulation (30 minutes) to prevent hemolysis. Send 0.75 mL of serum refrigerated in a plastic vial.
Secondary ID
75455Useful For
Heavy and light chain pair quantitation may be useful for:
1. Distinguishing between broadly migrating monoclonal proteins and restricted polyclonal immunoglobulin patterns on serum electrophoresis.
2. Quantitating monoclonal IgM proteins that are difficult to quantitate using serum protein electrophoresis alone.
3. Providing a more specific quantitation of the monoclonal protein than total IgM measurements alone.
Method Name
Turbidimetric
Reporting Name
IgM Heavy Light Chains (HLC), SSpecimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 7 days | |
| Ambient | 7 days | ||
| Frozen | 7 days |
Reject Due To
| Hemolysis | Mild reject; Gross reject |
| Lipemia | Mild reject; Gross reject |
| Icterus | NA |
| Other | Microbially-contaminated specimen; specimen containing particulate matter |
Clinical Information
Elevated serum concentrations of monoclonal protein are indicative of an underlying abnormality, such as monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma, Waldenström's macroglobulinemia and other lymphoproliferative disorders. Serum protein electrophoresis (SPE) densitometry is recommended to quantify monoclonal proteins.
Nephelometry can also be used in these instances to measure total IgM, but this will include nontumor immunoglobulin, and measurement of either IgM Kappa or IgM Lambda may provide additional information regarding tumor production.
Reference Values
IgM Kappa (g/L): 0.29-1.82
IgM Lambda (g/L): 0.17-0.94
IgM Kappa:IgM Lambda ratio: 0.96-2.30
Interpretation
An elevated IgM heavy and light chain (HLC) pair ratio suggests a clonal proliferation of an IgM kappa clone of plasma cells.
A low IgM HLC pair ratio suggests a clonal proliferation of an IgM lambda clone of plasma cells.
Day(s) Performed
Tuesday, Friday
Performing Laboratory
LabCorp BurlingtonCPT Code Information
83883 x 2
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| FHLC | IgM Heavy Light Chains (HLC), S | Obsolete |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| Z5399 | IgM Kappa, S | 74866-5 |
| Z5400 | IgM Lambda, S | 74867-3 |
| Z5401 | IgM K/L HLC Ratio | 74870-7 |