Immunoglobulin G paraprotein cross-reactivity with immunoglobulin M measurement

Ann Clin Biochem 2008;45:431-433
doi:10.1258/acb.2008.007236
© 2008 Association for Clinical Biochemistry

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Case Reports


Robert C Hawkins and
Lian-King Lee


Department of Pathology and Laboratory Medicine, Tan Tock Seng Hospital, Singapore 308433


Corresponding author: Dr Robert Hawkins. Email: Robert_Hawkins{at}ttsh.com.sg

We report a case of IgG paraprotein cross-reactivity with IgM measurement in a patient with IgG{kappa} multiple myeloma and associated IgA and IgM immune paresis. IgM measurements using a Beckman-Coulter Synchron LX IgM reagent initially gave unmeasurably low IgM concentrations (<0.3 g/L) but IgM quantitation using later batches of reagent gave IgM concentrations of 13–42 g/L. Immunofixation confirmed the continued presence of the IgG{kappa} paraprotein band with suppression of IgA and IgM and analysis on the Behring BN2 and Beckman-Coulter Immage instruments showed IgM concentrations of <0.2 g/L. Immunofixation using the Synchron LX IgM reagent as antiserum confirmed binding of the Synchron LX IgM antiserum to the IgG{kappa} paraprotein. This case highlights the importanceof checking all unexpected immunoglobulin measurements withprevious results and immunofixation findings to avoid mistakes.


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